Members

• List of Services and Supplies Requiring Precertification
  • HMAA
  • Hawaii Electricians Health and Welfare Fund
  • Charter Communications (formerly Oceanic Time Warner Cable)
• Interisland Access to Care Program – Travel Request Form
  • HMAA and Charter Communications
• Services Rendered by a Non-Participating Provider
• Services Outside Hawaii – Please read these instructions if you are planning to travel outside Hawaii.
  • Services on the U.S. Mainland
  • Services Outside the United States

• Coordination of Benefits (COB) Questionnaire
  • HMAA
  • Hawaii Electricians Health and Welfare Fund
  • Charter Communications
• Third-Party Liability Questionnaire and Agreement
  • HMAA
  • Hawaii Electricians Health and Welfare Fund
  • Charter Communications

• Colorectal Cancer Screening – Free At-Home Test Kit
• Baby & Me – Free Maternity Incentive Program
• Member Plus Discount Program
• The Active&Fit^® Programs

Our pharmacy benefit manager, OptumRx, helps members manage their prescriptions. View further information.

• Medicare Part D Notice of Creditable Coverage
• Health Insurance Marketplace Coverage Options

• Privacy Practices for Personal Health Information
• Authorization for Release of Personal Health Information
• Privacy Complaint Form