For their health. For those they love most. For life.

HMSA health plans for employers

2020

We’re here for your employees

We’ve got your business covered

Looking for a quality health plan for your company? Whether you have one employee or 50, we can help you choose the right plan for your needs. Our plans offer you and your employees:

• Freedom of choice. Your employees can choose their own doctors and hospitals from a large local network.

• After-hours care. Your employees have several convenient ways to get care after business hours.

• Access to care when they travel. Your employees can go to doctors and hospitals on the Mainland and in many locations worldwide.

Read on to learn more about our benefits and programs.

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How do I shop for a health plan?Contact us today. We’re happy to help you choose a medical plan for your company. Need a dental plan, too? See page 6 to learn more.

Online. Go to hmsa.com/health-plans/employers.

By phone. Call us at 948-5555, option 2, on Oahu or 1 (800) 620-4672, option 2, toll-free on the Neighbor Islands. Our licensed sales professionals are available Monday through Friday, 8 a.m. to 5 p.m.

In person. Visit us at an HMSA Center or office. For locations and hours, see the back cover.

2

Where can my employees go for care?

With thousands of doctors and other health care providers to choose from, it’s easy for your employees to get the care they need. They can also:

• Connect with a doctor quickly and without an appointment on their computer or mobile device from anywhere in Hawaii with HMSA’s Online Care®.

• Treat a minor illness or injury in the evening or on the weekend at a participating urgent care clinic or CVS/minuteclinic in selected Longs Drugs stores on Oahu.

• Get specialty care at hospitals recognized for their expertise in quality and cost-effective specialty care.

• Use vision and prescription drug benefits as soon as their plan starts if those benefits are included in their plan.

AmericanWell® is an independent company pro-viding hosting and software services for HMSA’s Online Care platform on behalf of HMSA.

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How can my employees get care when traveling?With HMSA, your employees can go to doctors and hospitals in the Blue Cross Blue Shield network on the Mainland and in more than 190 countries and territories worldwide. Nationwide, 96% of hospi-tals and 95% of physicians are in the Blue Cross Blue Shield network. To learn more about benefits on the Mainland, go to bcbs.com. For benefits in another country, visit bcbsglobalcore.com.

4

Do your plans offer health and fitness discounts?

Yes! Your employees can save money on health-related products and services including gym memberships, acupuncture, and massage therapy. They can also:

• Attend an HMSA health education workshop at no cost.

• Try a healthy recipe from Island Scene, HMSA’s member magazine.

• Contact the Hawai‘i Tobacco Quitline to quit smoking. Your employees can call 1 (800) QUIT-NOW or 1 (800) 784-8669 toll-free.

To learn more about these tools and programs, go to hmsa.com/well-being.

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What online tools are available to employers?

What online tools are available to my employees?

Our self-service online tools make it easy for you to administer your group’s health plan. With HMSAenroll, you can add or remove employees and their dependents from your plan online. You can also pay your bill securely using VueBill. To register, visit vuebill.com/hmsa.

Your employees can access their health plan information online at hmsa.com.

Click Member Login to:

• Request or print a copy of their HMSA membership card.

• Use an annual maximum out-of-pocket calculator to see how much they need to pay for covered services in a plan year.

• See if they’ve reached their plan’s deductible if their plan has one.

• See the health care services they’ve used and how much they’ve paid for them.

• View their Guide to Benefits, which has details about their health plan.

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How do I shop for a dental plan for my employees?

Call or visit us to shop for a dental plan for your employees.

With HMSA’s dental PPO plan, your employees can choose from over 90% of the dentists in Hawaii and access to a national network of dentists when visiting the Mainland. One of the best features of the PPO dental plan is calendar year rollover, which allows members to apply unused benefits to the following year. These rollover dollars can help pay for unexpected visits or higher out-of-pocket costs for complex procedures.

HMSA’s dental HMO plan is the only dental HMO offering from a Hawaii-based insurer. These plans typically have low copayments and no calendar year maximum to help your employees manage out-of-pocket costs. With this plan, they’ll have access to the largest HMO dentist network in Hawaii that continues to expand.

Members who have certain medical conditions, such as diabetes and heart disease, may be eligible to receive additional dental services at no cost through our Oral Health for Total Health program. These enhanced dental benefits can improve their oral health and help them manage their medical condition. Qualifying members who also have an HMSA medical plan may be enrolled in the program automatically.

To learn more, go to hmsadental.com/employers.

Pediatric dental benefits are required by the Affordable Care Act (ACA). Although our medical plans don’t include pediatric dental benefits, you can get an HMSA dental plan to cover yourself and eligible family members.

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What other plans are available?

You can buy supplemental plans such as group term life insurance, temporary disability insurance, accidental death and dismemberment, complementary care, and more. Call or visit us to learn more.

98

HMSA Small Business PlansChoose a health plan that meets your employees’ needs.

Plan Benefits

A StatusEmployers pay at least half of employees’ premiums; employees are responsible for the balance.

The employees’ portion can’t exceed 1.5% of their gross monthly wages.

B Status Employers’ contribution toward family premiums must equal the required single rate contribution plus half the

difference between single and family rates.

Preferred Provider Plan

Health Plan Hawaii Gold

Health Plan Hawaii Plus CompMED CompMED Choice Preferred

Provider Plan

Monthly premiums*Premiums are based on a 21-year-old nonsmoker. Actual premiums will be based on an applicant’s age on the plan’s effective date.

$339.43 $290.41 $333.71 $335.17 $326.05 $293.07

Annual medical deductible (single person)The amount you pay out of pocket before your plan benefits start.

$0 $0 $0 $0 $200 $350

Annual medical maximum out of pocket (single person) $2,500 $2,500 $2,500 $2,500 $2,200 $3,000

Annual prescription drug deductible (single person) $0 $1,500 $0 $0 $0 $500

Annual prescription drug maximum out of pocket (single person) $5,650 $5,650 $5,650 $5,650 $5,950 $5,150

EMPLOYEES’ OUT-OF-POCKET COST EMPLOYEES’ OUT-OF-POCKET COST

CoinsurancePercentages represent most of the plan’s benefits. For a complete list of coinsurance percentages, check the plan’s Guide to Benefits.

10%–20% 20% 10%–20% 20% 20%† 20%†

Doctor/specialist office visit $12/$12 $20/$20 $20/$20 $14/$20 $12/$12 $20†/$20†

Ambulance 20% 20% 20% 20% 20%† 20%†

Emergency room 20% 20% $100 20% 20%† 20%†

Prescription drugsGeneric/preferred/other brand name/specialty(30-day supply).

$7/$30/ $75**/$100

$30/50%†/ 50%†/50%†

$7/$30/ $75**/$100

$7/$30/ $75**/$100

$10/$50/ $100***/$200

$15†/$60†/ $120****†/$200

Generic drugsAvailable before you reach the deductible. *****

This is only a summary.

All benefits are for services received from a participating provider.

This comparison shows prescription drug copayments for four of five tiers covered under these plans.

* These rates can change depending on the plan’s effective date. ** $30 copayment plus $45 other brand name cost share. *** $50 copayment plus $50 other brand name cost share. **** $60 copayment plus $60 other brand name cost share. ***** 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.

† Deductible applies.

(00) 4000-161006 2.20 cs

Serving youMeet with knowledgeable, experienced health plan advisers. We’ll answer questions about your health plan, give you general health and well-being information, and more. Visit hmsa.com for directions.

HMSA Center @ Honolulu818 Keeaumoku St.Monday through Friday, 8 a.m.–5 p.m. | Saturday, 9 a.m.–2 p.m.

HMSA Center @ Pearl CityPearl City Gateway | 1132 Kuala St., Suite 400 Monday through Friday, 9 a.m.–6 p.m. | Saturday, 9 a.m.–2 p.m.

HMSA Center @ HiloWaiakea Center | 303A E. Makaala St. Monday through Friday, 9 a.m.–6 p.m. | Saturday, 9 a.m.–2 p.m.

HMSA Center @ KahuluiPuunene Shopping Center | 70 Hookele St.Monday through Friday, 9 a.m.–6 p.m. | Saturday, 9 a.m.–2 p.m.

Customer Relations representatives are also available in person at our Neighbor Island offices, Monday through Friday, 8 a.m.–4 p.m.:

Kailua-Kona 75-1029 Henry St., Suite 301

Lihue 4366 Kukui Grove St., Suite 103

Contact HMSA. We’re here for you.

Call 948-5555, option 2, on Oahu or 1 (800) 620-4672, option 2, toll-free on the Neighbor Islands or Mainland.

Together, we improve the lives of our members and the health of Hawaii. Caring for our families, friends, and neighbors is our privilege.

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