Active Employees Retirees Part-time & Temporary Employees HSTA VB

Active Employees

Please note that the current rate sheets available reflect the July 1, 2018, to June 30, 2019, employer contributions. The employers and unions are currently negotiating the July 1, 2019, to June 30, 2020, employer contribution. Once they're finalized, the EUTF will update the rate sheets.

Available 2019 plans

See the details of your plan, including what you’ll pay when you go to the doctor or hospital.

Open enrollment for EUTF members is April 1-30.

Happy with your HMSA plan? You don’t have to do anything to keep it.

Looking for an HMSA plan? Now’s the time to join.

Questions? Attend an open enrollment session with an HMSA health plan adviser. They’ll be happy to explain our health plans and answer your questions.

View Schedule

Actives OE Brochure
2019 plan brochure

Summary of all plans

Download
Actives Presentation
2019 presentation

Presentation for open enrollment.

Download
Actives Presentation
75/25 PPO flier

Basics about the 75/25 plan

Download

2019 plan summary

Benefits shown are for services received from an in-network provider.

Not sure what plan is right for you? Find out!

Is this plan right for you?

HMO Plan

This plan gives you access to our health maintenance organization (HMO) network. You’ll choose a health center and primary care provider to coordinate all your care.

90/10 PPO Plan

This plan pays for 90 percent of most health care costs after the deductible is met. You’ll pay the remaining 10 percent.

80/20 PPO Plan

This plan pays for 80 percent of most health care costs after the deductible is met. You’ll pay the remaining 20 percent.

75/25 PPO Plan

This plan pays for 75 percent of most health care costs after the deductible is met. You’ll pay the remaining 25 percent.

Annual deductible
None

Annual deductible

In-network:
None

Out of network:
$100 per person
$300 maximum per family

Annual deductible

In-network:
None

Out of network:
$250 per person
$750 maximum per family

Annual deductible
$300 per person
$900 maximum per family

Annual Out-of-pocket Maximum

$1,500 per person
$3,000 maximum per family

Annual Out-of-pocket Maximum

$2,000 per person
$4,000 maximum per family

Annual Out-of-pocket Maximum

$2,500 per person
$5,000 maximum per family

Annual Out-of-pocket Maximum

$5,000 per person
$10,000 maximum per family

Plan Benefits


Annual Preventive Health Evaluation:
$0

Office Visits
$15

You pay $0 for these services:
  • Hospital Room and Board
  • Maternity Care
  • Diagnostic Tests Outpatient Laboratory
Surgical Procedures (outpatient surgery)
$0 (outpatient surgical center)
$15 (professional charges)

Outpatient X-ray and Other Radiology
$15 per X-ray

Emergency Room
$100

Ambulance (ground)
20%

Plan Benefits


Annual Preventive Health Evaluation:
$0

You pay 10% of costs for these services:
  • Office Visits
  • Hospital Room and Board
  • Maternity Care
  • Surgical Procedures (outpatient surgery)
  • Diagnostic Tests
  • Outpatient Laboratory
  • Outpatient X-ray and Other Radiology
  • Emergency Room
  • Ambulance (ground)

Plan Benefits


Annual Preventive Health Evaluation:
$0

You pay 20% of costs for these services:
  • Office Visits
  • Hospital Room and Board
  • Maternity Care
  • Surgical Procedures (outpatient surgery)
  • Diagnostic Tests
  • Outpatient Laboratory
  • Outpatient X-ray and Other Radiology
  • Emergency Room
  • Ambulance (ground)

Plan Benefits


Annual Preventive Health Evaluation:
$0

You pay 25% of costs for these services:
  • Office Visits
  • Hospital Room and Board *
  • Maternity Care *
  • Surgical Procedures (outpatient surgery) *
  • Diagnostic Tests *
  • Outpatient Laboratory
  • Outpatient X-ray and Other Radiology *
  • Emergency Room *
  • Ambulance (ground) *
Full plan benefit details
Full plan benefit details
Full plan benefit details
Full plan benefit details

Reference Guide

Plan forms

Every plan includes:

Annual preventive health exam

This important preventive care visit includes:

  • A health assessment.
  • A review of your health history.
  • Discussion of health risks.
  • Review of prior screening test results.
  • Additional screenings.
What’s the copayment or coinsurance?
$0 for PPO, HMO, and retiree plans

Chiropractic services

Chiropractic services from an ASH in-network provider:

  • $15 per visit
  • 20 medically necessary visits per calendar year

How to choose a chiropractor

Questions on chiropractic benefits?

Call for questions about your chiropractic benefits or to find a participating ASH Group network provider.

ASH Group Customer Service:
1-888-981-2746 toll-free

Monday - Friday:
2 a.m. to 5 p.m. HST

Saturday: 9 a.m. to 5 p.m. HST

*Annual deductible applies

HMO Plan

This plan gives you access to our health maintenance organization (HMO) network. You’ll choose a health center and primary care provider to coordinate all your care.

Annual deductible

None

Annual Out-of-pocket Maximum

$1,500 per person
$3,000 maximum per family

Plan Benefits


Annual Preventive Health Evaluation:
$0

Office Visits
$15

You pay $0 for these services:
  • Hospital Room and Board
  • Maternity Care
  • Diagnostic Tests Outpatient Laboratory
Surgical Procedures (outpatient surgery)
$0 (outpatient surgical center)
$15 (professional charges)

Outpatient X-ray and Other Radiology
$15 per X-ray

Emergency Room
$100

Ambulance (ground)
20%

Full plan benefit details

90/10 PPO Plan

This plan pays for 90 percent of most health care costs after the deductible is met. You’ll pay the remaining 10 percent.

Annual deductible

In-network:
None

Out of network:
$100 per person
$300 maximum per family

Annual Out-of-pocket Maximum

$2,000 per person
$4,000 maximum per family

Plan Benefits


Annual Preventive Health Evaluation:
$0

You pay 10% of costs for these services:
  • Office Visits
  • Hospital Room and Board
  • Maternity Care
  • Surgical Procedures (outpatient surgery)
  • Diagnostic Tests
  • Outpatient Laboratory
  • Outpatient X-ray and Other Radiology
  • Emergency Room
  • Ambulance (ground)
Full plan benefit details

80/20 PPO Plan

This plan pays for 80 percent of most health care costs after the deductible is met. You’ll pay the remaining 20 percent.

Annual deductible

In-network:
None

Out of network:
$250 per person
$750 maximum per family

Annual Out-of-pocket Maximum

$2,500 per person
$5,000 maximum per family

Plan Benefits


Annual Preventive Health Evaluation:
$0

You pay 20% of costs for these services:
  • Office Visits
  • Hospital Room and Board
  • Maternity Care
  • Surgical Procedures (outpatient surgery)
  • Diagnostic Tests
  • Outpatient Laboratory
  • Outpatient X-ray and Other Radiology
  • Emergency Room
  • Ambulance (ground)
Full plan benefit details

75/25 PPO Plan

This plan pays for 75 percent of most health care costs after the deductible is met. You’ll pay the remaining 25 percent.

Annual deductible

$300 per person
$900 maximum per family

Annual Out-of-pocket Maximum

$5,000 per person
$10,000 maximum per family

Plan Benefits


Annual Preventive Health Evaluation:
$0

You pay 25% of costs for these services:
  • Office Visits
  • Hospital Room and Board *
  • Maternity Care *
  • Surgical Procedures (outpatient surgery) *
  • Diagnostic Tests *
  • Outpatient Laboratory
  • Outpatient X-ray and Other Radiology *
  • Emergency Room *
  • Ambulance (ground) *
Full plan benefit details

Every plan includes:

Annual preventive health exam

This important preventive care visit includes:

  • A health assessment.
  • A review of your health history.
  • Discussion of health risks.
  • Review of prior screening test results.
  • Additional screenings.
What’s the copayment or coinsurance?
$0 for PPO, HMO, and retiree plans

Chiropractic services

Chiropractic services from an ASH in-network provider:

  • $15 per visit
  • 20 medically necessary visits per calendar year

How to choose a chiropractor

Questions on chiropractic benefits?

Call for questions about your chiropractic benefits or to find a participating ASH Group network provider.

ASH Group Customer Service:
1-888-981-2746 toll-free

Monday - Friday:
2 a.m. to 5 p.m. HST

Saturday: 9 a.m. to 5 p.m. HST

*Annual deductible applies

Annual deductible

If your plan has a deductible, it's the amount you pay each calendar year for certain services and products before your health plan pays.

The deductible doesn't apply to services such as preventive care, in-network primary care office visits, in-network specialist office visits, and in-network outpatient laboratory and pathology services.

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Out-of-pocket maximum

The out-of-pocket maximum is the most you'll have to pay per plan year for covered health care services. Once you reach this amount, your plan pays 100 percent of the allowed amount for covered services excluding taxes.

There's a maximum for each person on the plan and a maximum for everyone on the plan.

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Out of network

Providers in our network agree to charge set rates for services or products.

Providers who aren't in our network are called out-of-network providers. It usually costs more to see these providers because they don't have a contract with us to provide you with services at a set fee. In addition, visits to out-of-network providers may not apply to your plan's deductible.

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Which plan is right for you?

Here are a few things you may want to consider when choosing a plan.

Cost

Find a plan that fits your budget.

Doctors

See which type of provider network is right for you.

Risk

Decide what level of protection you need.

Cost

The total cost of your health insurance depends on your plan's premiums and out-of-pocket costs. Knowing how these work and what you're paying for can help make sure you’re not spending more than you need to.

Premiums are the payments you make for your health plan. You may pay the entire premium or just the part not covered by your employer, usually monthly.

When seeing a doctor, plans either mention a copayment or coinsurance, which is the amount you pay for covered services. The cap on your out-of-pocket costs is your out-of-pocket maximum.


I'd like to...

Keep premiums low Keep out-of-pocket costs low
Back

Doctors

When you’re choosing a health plan, one of the main things to consider is the plan’s network of doctors. Each health plan has a group of doctors who have an agreement with the health plan to charge a set amount for services. It’s best to see providers in our network to get the best value.

There are two types of plans with different doctor networks, preferred provider organization (PPO) and health maintenance organization (HMO) plans.

PPO plans let you see any provider you prefer in HMSA’s network of participating providers. PPO plans work best for people who value the freedom to choose.

HMO plans require you to pick one health center and a primary care provider (PCP) in that health center to provide or arrange your care. Your PCP will refer you to specialists and other health care providers in your health center when you need it.


I'd like to...

Have the freedom to choose your doctor Choose a health center
Back

Risk

Manage your financial risk against a major health event through a plan’s annual out-of-pocket max.

The out-of-pocket maximum is the most you will have to pay for health services for the calendar year. In the case of a major health event, where your out-of-pocket costs may amount to a number larger than you can handle, an out-of-pocket max is an important safeguard for you and your family.

The lower a plan's out-of-pocket maximum, the lower your financial risk for the plan year. However, you’ll usually pay higher premiums for more financial protection.


I'd like to...

Have financial protection from high health care costs Have lower premiums
Back

Because you told us that you would like to keep premiums low, keep out-of-pockets costs low, have the freedom to choose your doctor choose a health center and have financial protection from high health care costs have lower premiums , you may want to consider the following plans:

If a plan meets your criteria, up to three badges will display under the plan name.

By phone:

Monday – Friday: 7 a.m. to 7 p.m.
Saturday: 9 a.m. to 1 p.m.
808-948-6499 Oahu
1-800-776-4672 toll-free