The Best Health Plan Choice for Your Small Business Health plans to meet your needs.
We can meet your needs. Healthy employees can lead to a happier, more productive workplace. We ll help you choose health plans that deliver the best value to you and your employees. Wide range of plan options. Choose from a variety of health plans and riders to meet your employees health and budget needs. Health and wellness programs. Support for you and your employees to manage or help prevent chronic health conditions, stop smoking, and more. Care while away from home. If you or your employees need medical care while traveling, you re covered. Save with tax credits Your business may be eligible for tax credits to help pay for your group coverage if you have less than 25 full-time employees (or the equivalent of) and the average wage of your employees is less than $50,000. If you want to use tax credits, you must buy your HMSA plan in the Hawai i Health Connector (scheduled to open October 1). Your HMSA representative can help you choose a plan in the Hawai i Health Connector. There s a lot of paperwork to verify your eligibility and claim the tax credit, so check with your tax adviser.
What do we get with our health plan? Wellness exams. It s important that your employees see their doctor at least once a year. Keep them healthy and productive with an annual physical exam included in your plan. Generic drugs. Get low-cost generic drugs as soon as your coverage starts, even before you meet your deductible. HMSA s Online Care. Speak to doctors online or by phone at no charge. No appointment needed. Get quick access to HMSA participating providers without dealing with traffic and parking. Special savings. Receive discounts on hundreds of health and wellness products and services statewide with HMSA365. ExtraCare Health Card. Save up to 20 percent on health-related CVS Caremark-brand items that cost more than a dollar at Longs Drugs stores or online at www.cvs.com. Information and inspiration. See healthy recipes and fun stories about living well in our award-winning Island Scene magazine and at www.islandscene.com.
HMSA Group Plans Choose a health plan that meets your employees health needs. Plan Benefits Monthly premiums* Premiums are based on a 21-year-old nonsmoker and includes pediatric dental. Actual premiums will be based on an applicant s age. Deductible, single person The amount you pay out of pocket before your plan benefits start. Annual maximum out of pocket, single person Coinsurance Percentages represent most of the plan s benefits. For a complete list of coinsurance percentages, check the plan s Guide to Benefits. Preferred Provider Plan A Status Preferred Provider Plan B Status HMSA Small Business Plans Health Plan Hawaii A Status Health Plan Hawaii B Status CompMED A Status CompMED B Status Silver PPP (Doesn t comply with Hawaii Prepaid Health Care Act) $264.82 $242.70 $290.40 $288.88 $278.25 $259.45 $208.13 $0 / $100 participating/ nonparticipating $300 $0 $0 $0 $300 $2,500 $3,000 $2,500 $2,500 $2,500 $3,000 YOUR COPAYMENT $2,000 includes prescription drug deductible $5,500 includes prescription drug maximum out of pocket 10% 20% 10% 20% 20% 20% 30% Doctor visit $12 $17 $20 $20 $14 $17 $30 Ambulance 20% 20% 20% 20% 20% 20% 30% Emergency room 20% 20% $100 20% 20% 20% 20% Prescription drugs Generic/preferred/brand (30-day supply) Annual prescription drug deductible, single person Annual prescription drug maximum out of pocket, single person Generic drugs Available before you reach the deductible *These rates can change based on when coverage starts. $7 / $30 / $75 $7**/ $30 / $75 $7 / $30 / $75 $7 / $30 / $75 $7 / $30 / $75 $7**/ $30 / $75 $7**/ $30 / $75 $0 $500 $0 $0 $0 $500 $3,850 $3,350 $3,850 $3,850 $3,850 $3,350 ** Generic drugs are covered before you meet the deductible, excluding Single Source generic drugs (manufactured by a single pharmaceutical company) dispensed at a retail pharmacy. See deductible above See maximum out of pocket above ** ** ** This is only a summary. All benefits are for services received from a participating provider. For details about your coverage and costs, call 948-5555, option 3, on Oahu or 1 (800) 620-4672 toll-free on the Neighbor Islands. TTY users, call 711.
Which plan should I choose? When choosing a health plan, it s important to understand the type of plan that best meets the needs of you and your employees. I want the freedom to choose my doctors. Our Preferred Provider and CompMED plans give you the choice of doctors and specialists from the largest network in Hawaii and every major hospital in the state. I want care to be convenient for me. Our Health Plan Hawaii plans offer comprehensive medical coverage in a health maintenance organization (HMO) setting. You select a health center and a primary care provider, who coordinates all your care.
Why should I choose HMSA? You can count on us. Experience. Your health plan is financially secure and backed by 75 years of experience. Reliable. Generations of Island companies and organizations have put their trust in us. High value. You receive the best benefits at the most affordable price. Accessible. If you or your employees have questions, call us, visit us, or contact us online. Choice. You ll have thousands of Hawaii doctors and other health care providers to choose from. Convenience. You can receive care from doctors and hospitals in our network where it s convenient for you. Quality care. You deserve the best care. We work with Hawaii doctors and hospitals to keep you and your employees healthy. Peace of mind. If you or your employees have a medical emergency while traveling, you can go to a hospital or doctor anywhere on the Mainland that s part of the Blue Cross and Blue Shield Association.
We re here for you. Call your HMSA representative at 948-5555, option 3, or 1 (800) 620-4672 toll-free. Go to hmsa.com/reform for the latest health care reform news and sign up for our health care reform e-newsletter. For health care reform questions, you and your employees can call 948-6387 on Oahu or 1 (800) 465-4672 toll-free on the Neighbor Islands, Monday through Friday, 8 a.m. to 5 p.m.
HMSA CENTERS Visit one of our new HMSA Centers with extended and weekend hours: Honolulu, Oahu 818 Keeaumoku St. Monday through Saturday, 8 a.m.- 6 p.m. Phone: 983-7281 Pearl City Gateway (opening October 2013) Pearl City, Oahu 1132 Kuala St., Suite 400 Monday through Saturday, 9 a.m.- 7 p.m. Phone: 983-7282 Waiakea Center (opening December 2013) Hilo, Hawaii Island 325 E. Makaala St., Suite 303A Monday through Saturday, 9 a.m.- 7 p.m. Phone: 933-9093 OFFICES Visit your local HMSA office Monday through Friday, 8 a.m. - 4 p.m.: Hilo, Hawaii Island (closing December 2013 to reopen at Waiakea Center) 670 Ponahawai St., Suite 121 96720 Phone: 935-5441 Kailua-Kona, Hawaii Island 75-1029 Henry St., Suite 301 96740 Phone: 329-5291 Kahului, Maui 33 Lono Ave., Suite 350 96732 Phone: 871-6295 Lihue, Kauai 4366 Kukui Grove St., Suite 103 96766 Phone: 245-3393 PHONE 948-6111 on Oahu If you re calling from the U.S. Mainland, please call 1 (800) 776-4672. If you need to call a local Hawaii telephone number from the Mainland, the area code is 808. HMSA s mission is to provide the people of Hawaii access to a sustainable, quality health care system that improves the overall health and well-being of our state. hmsa.com myhmsa askhmsa HMSA Now (00) AMS 4000-2202 9.13 LE