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2024 Benefits Guide - Hawai'i

Medical Plan Options

You and your family have the choice to enroll in HMSA's Preferred Provider Organization (PPO) medical plan. This top-tier plan offers flexibility, allowing you to choose from a wide network of preferred providers for your medical needs. Plus, it includes prescription drug coverage, ensuring you have access to necessary medications without breaking the bank. With this plan, your well-being takes center stage, providing peace of mind and support for your health journey. Welcome to a world of quality healthcare and convenience.

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Image 1 Enrollment &
Eligibility
Image 2 Medical Plans
Image 3 Dental & Vision
Image 4 FSA
Image 1 Retirement
Planning
Image 2 Additional
Benefits
Image 3 Key Contacts &
Terms
Image 4 Important
Notices

Looking for Mental Health Info?

Mental Health Resources

Preferred Provider Organization (PPO)

  • Provides in- and out-of-network coverage, but you will get a greater level of coverage and it will typically cost you less to stay in-network
  • You pay copays for in-network office visits

  • You can pair this plan with an FSA to help pay for out-of-pocket expenses with pre-tax funds

Weekly Medical Costs

Tier

HMSA PPO 745 + Vision

 

Employee Only

$4.10

Employee + Spouse

$174.81

Employee + Family

$345.53
 
Coverage may be terminated for failure to timely pay premiums via payroll.

Deductibles &
Out-of-Pocket Maximum

 

 

HMSA PPO 745 + Vision
PPO Network

 

Calendar Year Deductible

Individual

 $200

Family

 $600

 

Calendar Year Out-of-Pocket Maximum 
(Out-of-Pocket Maximum Includes Deductible)

Individual

 $2,200

Family

 $6,600

Coinsurance/Copays
(What you will pay)

 

 

HMSA PPO 745 + Vision
PPO Network

 

Preventative Care

 No Charge

Primary Care Physician

 $12

Specialist

 $12

Physical Therapy

 $12

Radiology - General (e.g. X-Ray)

 Plan pays 80% after deductible

Radiology - Other (e.g. EMRI, CT Scan, Ultrasound)

 Plan pays 80% after deductible

Lab Tests (e.g. bloodwork)

  No Charge
Urgent Care
 $12
Emergency Room
 Plan pays 80% after deductible
Inpatient Hospital Room & Board
 Plan pays 80% after deductible
Inpatient Surgery
 Plan pays 80% after deductible
 

Pharmacy

 

 

HMS PPO 745 + Vision
PPO Network

 

Retail RX (Up to 30-days supply)

Pharmacy Deductible

 n/a

Generic

 $7

Preferred Brand

 $30

Non-Preferred Brand

 $75

 

Mail Order RX (up to 90-days supply)

Generic

 $11

Preferred Brand

 $65

Non-Preferred Brand

 $200

Need More Information?

Full Plan Summary

How to Get Started with My Account

As an HMSA plan member, My Account is your home base for personalized information about your medical plan. Register online today to access your benefit Information, ID cards, save money on prescriptions, use the HMSA Online Care tool and to find a provider.

  • Go to hmsa.com, click on Member Login and Register

  • Enter your email address and a password, agree to the Terms and Conditions and click Register.

  • You'll receive an email to validate your email address. Click the link in the email and log back in to My Account.

  • Click Add a Plan, enter the requested information and click Link Plans.

 

How to Find an HMSA Provider

Go to hmsa.com/search/providers and select Preferred Provider Plan (PPO)

HMSA Online Care with AmericanWell

When you don't feel well, the last thing you want to do is leave the comfort of your home to go sit in a waiting room. If you are enrolled in the HMSA medical plan, AmericanWell is here for you.

These virtual medical visits are a convenient option when you or your family have a minor medical issue (such as pink eye, rash, sore throat or allergies).

HMSA Online Care is very little to no cost to you with our medical plans. You can save time and money at home, and still get the help you need!

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Talk to a doctor anytime. Anywhere you happen to be

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Receive quality care on the HMSA mobile app

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Prompt treatment for anyone covered by a TCWGlobal medical plan

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Prescription sent to pharmacy of choice, if necessary

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It's free, cheaper than visiting the ER or Urgent Care

Employee Assistance Plan (EAP) with UNUM

All employees have access to our EAP at no cost to you. The EAP offers support for a wide range of work and personal issues to promote a healthy work/life balance. You typically have three free, confidential sessions per issue. Counselors are also available for referrals for additional care or to help with child/elder care services, finances, personal and legal issues.

Get help 24/7 from UNUM

UNUM.com
800-854-1446

Check Out the Full Benefits Guide

Benefits Guide
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