Contact our Customer Service Center
to file a complaint. If you are dissatisfied with our privacy practices or think your privacy rights have been violated, you may submit a Privacy Complaint Form
If you are enrolled in a group health plan and would like to appeal HMAA’s decision, you must do one of the following:
- For appealing an issue of medical necessity, appropriateness, health care setting, level of care, or effectiveness, or a determination by HMAA that the service or treatment is experimental or investigational and you meet the requirements of Hawaii Revised Statutes Chapter 432E: Request review by an independent review organization (IRO) selected by the Hawaii Insurance Commissioner. You must ask for review by an IRO within 130 days of the decision. The following forms must be submitted to request external review by an IRO.
- For appealing all other issues: File a lawsuit against HMAA under 29 USC 1132(a) unless your plan is one of the three bulleted types below in which case you must request arbitration before a mutually selected arbitrator:
- A church plan as defined in 29 USC 2002(33) and no selection has been made in accord with 26 USC 410(d), or
- A governmental plan as defined in 29 USC 1002(32).
- A sole proprietor
For further information and requirements, please review HMAA’s Appeals Procedure or contact our Customer Service Center.