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HMAA launches refreshed identity. |
This is the maximum amount on which payment is based for covered health care services. This may also be called “allowed amount,” “eligible expense,” “payment allowance,” “contracted rate,” or “negotiated rate.” HMAA’s payment is based on the eligible charge, not the billed charge. If the provider is not in our network, the rate is based [...]
A deductible is the amount you owe for services that your health insurance or plan covers before your health insurance or plan begins to pay. For example, if your deductible is $1,000, your plan won’t pay benefits until you’ve met your $1,000 deductible for covered services which are subject to the deductible. The deductible may [...]
Yes, employers still need to comply with the Hawaii Prepaid Health Care Act, which requires employers to provide health coverage for employees who work 20 hours or more a week for four consecutive weeks. Employees cannot contribute more than 1.5% of their wages. Employers are not responsible for providing coverage for employees who do not [...]
The impact to your health insurance costs and benefits, including out-of-pocket expenses and deductibles, will depend on your group’s business size and grandfathered status. For small businesses, it also depends on your employee demographics, including their ages. With the additional benefits and new federal fees and taxes mandated by the Affordable Care Act, your cost [...]
Grandfathered status applies to health plans that were in effect on March 23, 2010 and did not conduct any action that would cause the plan to lose grandfathered status in accordance with Health Care Reform and Department of Labor regulations. You may also view our frequently asked questions regarding grandfathered health plans for more information. Grandmothered status applies [...]
Under a transitional policy outlined by former President Obama and approved by the Hawaii Division of Insurance in 2013, health insurers are able to continue coverage that would otherwise be terminated, cancelled or modified as a result of the Affordable Care Act (ACA) compliant policy and rate structure. Since then, CMS announced a number of [...]
The “Pay or Play” provision applies to Applicable Large Employers (ALEs) with an average of at least 50 full-time employees, including full-time equivalents (FTEs), working at least 30 hours per week on business days during the preceding calendar year. Essentially, ALEs may “Pay” a penalty if they do not “Play” by the rules of offering minimum [...]
HMAA is currently required to collect and remit the following taxes and fees created by the Affordable Care Act, which may or may not have an impact on your premium rates at this time, depending upon your group’s circumstances. Please contact your HMAA Account Manager or email AccountManager@hmaa.com for more information on the specific amount or collection [...]
If you suspect health care fraud, waste, or abuse by an HMAA group, member, provider, or other individual or entity, report it to HMAA at stopfraud@hmaa.com or contact our Customer Service Center.
For information about the Affordable Care Act (ACA), please visit our Health Care Reform FAQs section or healthcare.gov. Please consult with your attorney regarding any legal questions.
