HMSA AGE-RATED SHOP PLANS
These plans are for employees of companies that participate in KIAA Age-Rated SHOP Plans. Double-check with your employer if you are unsure what plans you have.
summary of benefits & coverage
New for 2024-2025 Plan Year
benefit summaries
COMPCARE (Acupuncture, Massage, and Active & Fit)
guide to benefits
New for 2024-2025 Plan Year
USEFUL FORMS & OTHER INFORMATION
FORMS
Group Life Enrollment Form - This form is for the Group Life benefit. You will need to fill out sections 1 and 3. You must include SSNs and DOBs of your beneficiaries. This form can be updated at any time.
Coordination of Benefits - This form is for individuals that have more than one health plan, that may include Medicare, Medicaid, TriCare, other private insurance.
Authorized Representative - This form is to authorize another individual to speak on your behalf with HMSA.
Care Access Assistance Program (CAAP) - If you need assistance with travel for medical purposes.
Away From Home Care - Guest Membership Program - If you choose an HMO plan and you or your dependent(s) are away from home, you this form to ensure you are covered while traveling for extended periods of time. This is great for students attending college on the mainland.