The state mandates that all employer-sponsored insurance plans provide certain benefits for their beneficiaries. In addition to these mandated benefits, some HMSA plans may provide additional services, higher age limits and/or higher benefit maximums.
Qualified Providers
In compliance with the provisions of the Hawaii Revised Statutes (Chapter 431M), HMSA requires that the treating provider possess one of the following certifications:
- Certified Substance Abuse Counselor (CSAC)
- Certified Substance Abuse Program Administrator (CSAPA)
- American Society of Addiction Medicine (ASAM)
- Board Certification in Addiction Psychiatry
- Proficiency Certification by the American Psychological Association College of Professional Psychology in the Treatment of Alcohol and Other Psychoactive Substance Use Disorders
- Licensed Clinical Social Worker (LCSW)
- Advanced Practice Registered Nurse ( APRN )
Exceptions
The plans listed below are exempt from the state mandate.
Federal Employee Plan (FEP)
Federal Employee Health Benefits (FEHB) Program
Coverage codes 104, 105, 106, 111, 112, 113, 131, 132 and 133 identify the FEP FEHB Program, a nationwide health insurance program for federal employees that is distinct from the HMSA Federal Plan 87, a Hawaii plan. For information on coverage for FEP, see Federal Employee Program (FEP).
Postal Service Health Benefits (PSHB) Program
Coverage codes 33D, 33E, 33F, 33A, 33B, 33C, 35A, 35B, and 35C identify the FEP PSHB Program, a nationwide health insurance program for postal employees that is distinct from the HMSA Plan for Postal Service Employees, a Hawaii plan. For information on coverage for FEP, see Federal Employee Program (FEP).Federal Plan 87
The Federal Employees Health Benefits Plan 87 (Fed 87) benefits are payable when they are medically appropriate.
HMSA Plan for Postal Service
The HMSA Plan for Postal Service benefits are payable when they are medically appropriate.
Revision History
| Date | Nature of Revision |
|---|---|
| 08/03/2026 | Migrated to new platform |