HMAA offers the following health plan options to large businesses. The Hawaii Insurance Commissioner has confirmed the State of Hawaii definitions are as follows:

  • Small Group: 1 to 50 full-time equivalent employees (FTEs)
  • Large Group: 51 or more FTEs

Group size is determined as follows:

  • Under the Affordable Care Act (ACA), an FTE is an employee who worked at least 30 hours per week during the preceding calendar year, and part-time employees are included in the calculation. Example: 3 employees each working 20 hours per week = 2 FTEs.
  • Companies with a common owner or are otherwise related are generally combined and treated as a single group, and employees are combined for purposes of determining group size.

Large businesses are not required to include Drug and Pediatric Benefits in their medical plans and are subject to different rating guidelines from Small businesses under the ACA’s Essential Health Benefits provisions; therefore, it is important to accurately determine your group size. Be sure to review our eligibility guidelines for additional information.

Note: HMAA’s plan documents for the 2026 coverage period is approved by the Hawaii Insurance Division.