HMSA - All of Hawaii

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General Information

Plan Name:	HMSA
Service Area:	All of Hawaii
Brochure:	PDF Version
Brochure:	Text Version
NCQA Accreditation:	No
JCAHO Accreditation:	No
URAC Accreditation:	No
Plan Type:	POS
Enrollment Code-Self:	871
Enrollment Code-Self & Family:	872
Link to Plan Home Page:	http://www.hmsa.com
Telephone:	808/948-6499
Summary results of the 2001 consumers assessment of health plans survey

Benefits

In Network - Doctor Care/ Primary Office Visits:	20%
In Network - Hospital Inpatient Room and Board Charges:	none
In Network - RX/ Generic/ Retail:	$5
In Network - RX/ Brand/ Retail:	$15
In Network - RX/ Brand/ NonFormulary:	$15
Out of Network - Doctor Care/ Primary Office Visits:	30%
Out of Network - Hospital Inpatient Room and Board Charges:	30%
Out of Network - RX/ Generic/ Retail:	$5 + 20%
Out of Network - RX/ Brand/ Retail:	$15+20%+
Out of Network - RX/ Brand/ NonFormulary:	$15 or 50%+

Rates

Non-Postal
___Twice Biweekly	Self: $53.78	Self: & Family: $119.72
___Biweekly	Self: $26.89	Self: & Family: $59.86
___Monthly	Self: $58.27	Self: & Family: $129.70
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Annuitants
___Monthly	Self: $58.27	Self: & Family: $129.70
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U.S. Postal Service Employees (Type A)
___Biweekly	Self: $12.10	Self: & Family: $26.94
___Monthly	Self: $26.22	Self: & Family: $58.36
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U.S. Postal Service Employees (Type B)
___Biweekly	Self: $12.10	Self: & Family: $26.94
___Monthly	Self: $26.22	Self: & Family: $58.36
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Worker's Compensation Recipients
___Twice Biweekly	Self: $53.78	Self: & Family: $119.72
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Certain Temporary Employees
___Biweekly	Self: $107.57	Self: & Family: $239.44
___Monthly	Self: $233.07	Self: & Family: $518.79
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Former Spouse Enrollees
___Monthly	Self: $233.07	Self: & Family: $518.79
___Biweekly	Self: $107.57	Self: & Family: $239.44
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Temporary Continuation of Coverage
___Monthly	Self: $237.73	Self: & Family: $529.17
___Biweekly	Self: $109.72	Self: & Family: $244.23
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FDIC
___Biweekly	Self: $12.10	Self: & Family: $26.94
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