- Employee increased hours worked to 20 per week, for four consecutive weeks
- Involuntary loss of coverage from another health plan
- Employee is entitled to additional benefits or coverage due to a change in employment status or meeting other eligibility requirements established by the employer
- Newborn child or newly adopted dependent
- Marriage or civil union
Employer – General FAQs
- I am interested in enrolling our company with HMAA. How do I get started?
- Where may I access forms for administering our health plan with HMAA?
- I received a ZixCorp secure email message from HWMG or HMAA. How do I open or reply to the message?
- When does an employee become eligible for coverage?
- When is my open enrollment period?
- When may I add an employee or dependent outside of open enrollment?
- How can I make sure my employees are enrolled without delays or returned applications?
- What should I do if one of my employees would like to waive health coverage?
- I overlooked notifying HMAA about a terminated employee. May I retroactively terminate his/her coverage?
- When are premium payments due? What happens if my payment is late?
- Where should I send my premium payment?
- My premium bill includes an employee who has terminated. Should I adjust my bill?
- Does my company need to offer COBRA coverage?
- How can my employees obtain evidence of their coverage period with HMAA?
- How can I find out if a healthcare provider is a participating provider with HMAA?
- How can I access my group’s benefit and claim information online?
- Why can’t my employees access information about their spouse or adult children?
- What other benefits and discounts are available to us as an HMAA employer group?
- What can I do to improve the health and wellness of my employees?
- Where can I find information about the Affordable Care Act (ACA)?
I am interested in enrolling our company with HMAA. How do I get started?
Thank you for your interest in HMAA! Simply contact our Sales Support Department for assistance. We look forward to hearing from you!
Where may I access forms for administering our health plan with HMAA?
I received a ZixCorp secure email message from HWMG or HMAA. How do I open or reply to the message?
To open or reply to a ZixCorp secure email message you received from HWMG or HMAA, view our instructions and frequently asked questions regarding our Secure Message Center.
When does an employee become eligible for coverage?
Employees are generally eligible for coverage on the first day of the month following at least 20 hours per week of employment for four consecutive weeks, and earning at least 86.67 times the minimum hourly wage per month. Please refer to your Company’s policy on enrollment and the Hawaii Prepaid Health Care Act for more information about employee eligibility.
When is my open enrollment period?
Your open enrollment period is each anniversary of your group’s HMAA coverage, at which time employees may make changes to their coverage including enrolling dependents, and employers can make changes to their health benefits package. Please note that any changes must be requested prior to your group’s coverage anniversary date.
When may I add an employee or dependent outside of open enrollment?
Eligible employees and/or their dependents may be enrolled outside of open enrollment only if a qualifying event occurs. Members must enroll within 30 days of the qualifying event. Qualifying events may include the following:
Please refer to your Company’s policy on enrollment.
How can I make sure my employees are enrolled without delays or returned applications?
Before submitting enrollment applications to HMAA, please ensure they are complete and accurate, including the following:
- When an employee enrolls a dependent, ensure that the dependent’s Social Security number (SSN) is submitted in the “Dependent Enrollment Information” section of the application. Due to federal requirements, SSNs are required for all persons enrolling. For newborns, HMAA will allow up to one year for submission of the SSN.
- The enrollment application must be signed and dated by the employee, verifying that the information is correct, within 60 days of the coverage effective date. If the employee’s spouse or civil union partner is also enrolling, he/she must also sign the application.
- For all qualifying events, applications must be submitted within 30 days of the event, even if the subscriber already has family coverage, and proof of eligibility (e.g., birth certificate, state-issued marriage or civil union certificate, court order, adoption records, HIPAA certificate) must accompany the application.
What should I do if one of my employees would like to waive health coverage?
According to the State of Hawaii Department of Labor and Industrial Relations (DLIR), the following categories of employees can claim an exemption from coverage:
- Those covered by a Federally established health insurance or prepaid health care plan, such as Medicare, Medicaid or medical care benefits provided for military dependents and military retirees and their dependents;
- Those covered as dependents under a qualified health care plan;
- Those who are recipients of public assistance or covered by a State-legislated health care plan governing medical assistance; and
- Those who are followers of religious groups who depend upon prayer or other spiritual means for healing.
To claim an exemption or individual waiver, an employee must complete and submit “Employee Notification to Employer” (Form HC-5) to the employer. The employer retains the original and gives a copy to the employee. The employer sends a copy to the DLIR in certain circumstances. The waiver is binding for one year and must be renewed every December 31. For further information, please visit the DLIR website.
I overlooked notifying HMAA about a terminated employee. May I retroactively terminate his/her coverage?
All terminations must be submitted in writing on or before the last day of the month in which eligibility ends. Please use the Member Change or Termination Form for terminations. A group health plan cannot rescind coverage with respect to an individual unless he/she performs an act, practice, or omission that constitutes fraud or intentional misrepresentation of material fact, as prohibited by the terms of the plan or coverage, or due to non-payment of premium. For more information, please consult with your legal counsel or visit www.healthcare.gov.
When are premium payments due? What happens if my payment is late?
Your full premium payment must be received no later than the first day of the month in which coverage is expected. If we do not receive payment in full, you will receive a notice of our intent to cancel your policy. Because this is a prepaid plan, claims incurred during months with unpaid premiums will be denied. Notification of termination will also be sent to the State of Hawaii.
Where should I send my premium payment?
Please make checks payable to HMAA. Mail your payment, along with the stub from your premium bill, to:HMAA
P.O. Box 29790
Honolulu, Hawaii 96820-2190
My premium bill includes an employee who has terminated. Should I adjust my bill?
To avoid claims payment delays and other issues, we advise against adjusting your statement balance. HMAA will make all billing adjustments, which will appear on the following month’s statement.
Does my company need to offer COBRA coverage?
COBRA coverage is available for employers that have at least 20 employees for at least 6 months in the previous calendar year. Both full-time and part-time employees are counted to determine whether a plan is subject to COBRA. Each part-time employee counts as a fraction of a full-time employee, with the fraction equal to the number of hours that the part-time employee worked divided by the hours an employee must work to be considered full-time. For more information about COBRA, visit the U.S. Department of Labor’s website at www.dol.gov/ebsa.
How can my employees obtain evidence of their coverage period with HMAA?
Subscribers (covered employees) and dependents aged 18+ may access their coverage information by logging into their Online for Members account. Once logged in, select the desired member to view, print or download an image of the Coverage Information page, which reflects the member’s name, ID number, and coverage period, and can be used as evidence of coverage. You may also contact our Customer Service Center for assistance.
- How can I find out if a healthcare provider is a participating provider with HMAA?
How can I access my group’s benefit and claim information online?
HMAA provides certain groups free 24/7 online access to benefits, eligibility maintenance, and other administrative functions. Click on the following link to access Online for Group Administration. Certain requirements apply.
Why can’t my employees access information about their spouse or adult children?HMAA respects the privacy and confidentiality of protected and individually-identifiable health information (PHI and IIHI). Once a dependent turns 18 years old, his/her parent or guardian will no longer have the right to access the dependent’s health or insurance records without authorization from the dependent. This policy is in accordance with Federal and State confidentiality laws regarding health care and minors’ rights. Certain exceptions may apply.
Members may complete and submit a written authorization to authorize the disclosure of their personal health information to another person or entity.
What other benefits and discounts are available to us as an HMAA employer group?
We are pleased to offer our employer groups special offers and discounts through Business Alliance Hawaii, a division of HMAA that supports our small and mid-sized business community. Our goal is to provide HMAA Employer groups and their members with essential products and services that save time and money, and help their business succeed.
What can I do to improve the health and wellness of my employees?
We invite you to explore our Health & Wellness Programs. Helping your employees take care of their health is important, not only to help them feel their best, but for the health of your business. Our health and productivity solutions give your employees the empowerment and support they need to take better care of themselves which can help reduce employee stress, job burnout, absenteeism, and health-related costs by creating a healthier workplace.
Where can I find information about the Affordable Care Act (ACA)?
Let us know how we can improve on our tools and services by completing a Satisfaction Survey.