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Coverage Options (other than COBRA) forMedical, Drug, Vision and DentalIndividual Plans(Changing from Employer Sponsored Group Health Coverage to HMSA or Kaiser IndividualCoverage)Overview of Individual Plans: Individuals are eligible to enroll in Individual Plans through HMSA or Kaiser (no other carrierscurrently offer individual plans in Hawaii) as long as you apply for this coverage within 60 days oflosing your group coverage (Special Enrollment Period, or SEP).The effective date of Individual plan coverage will be the 1st of month following when you enroll(as long as you enroll within the 60 day SEP)There may be a 1-2 month lapse in coverage based on when you enroll, so it is best to enroll assoon as you know you will lose coverage to be sure your coverage starts the 1st of monthfollowing loss of other coverage.If you miss the 60 day eligibility window, you may enroll only during the annual Open Enrollmentperiod of Nov. 15th through Dec. 15th, with coverage to take effect Jan.1st.Individual plans are required to provide Medical and Drug coverage for adults, and Medical,Drug, Vision and Dental coverage for children ages 0-21.Individual plans rates are based on age.Benefits choices- 4 Metallic “Levels”: Bronze 60% coverage, Silver 70% coverage, Gold 80%coverage, Platinum 90% coverage4 things to be aware of when choosing an individual plan:1. Premium: How much you will pay per month for the coverage. The lower the premium, thelower the coverage.2. Coverage Levels: What percent of the charges will the plan pay? Plans pay based on participatingproviders. If you see non-participating providers, your cost will be greater.3. Deductible: How much you will have to pay upfront, before coverage will begin. Check whichservices will require you to meet the deductible before you are covered.4. Annual Out of Pocket Maximum: This is the maximum you will pay during a calendar year indeductibles, co-insurances, and co-payments (for participating providers only). Once you’ve hitthe out-of-pocket maximum, you are covered at 100% for the rest of the calendar year (with theexception of taxes for HMSA PPO plans). There can be a separate OOP max for medical coverageand drug coverage. Premium x 12 months, plus the Medical and Drug OOP max. is the most youwill need to invest for the calendar year (taxes not included for PPO plans), if you experience acatastrophic medical event, as long as you are seeing participating providers.1Rev. 072820

Options for Individual Plans:HEALTHCARE.GOV (Federal Health Insurance Marketplace): Individuals who have no access to other employer sponsored coverage (through another job,spouse or parent) may qualify for federal premium subsidies if they apply for an individual planthrough the federal health insurance Marketplace. Premium subsidies are only available if the individual’s household income falls between 138%and 400% of the federal poverty level. CONTACT: HealthCare.Gov at 1-800-318-2596, or visit healthcare.gov/ HMSA/KAISER DIRECT:Individuals who have access to other employer sponsored coverage (e.g., as a dependent, but itis too costly) and are not eligible for federal premium subsidies, may enroll in an individual plandirectly through HMSA or Kaiser.Individual plan benefits and premiums are the same whether purchased through the federalMarketplace or directly through the carrier. HMSA: 808-948-5555, or visit hmsa.com/health-plans/individuals-families/ KAISER: 1-800-488-3590 or visit ance#1getaquoteMED-QUESTThe State of Hawaii Med-QUEST Division (MQD) provides eligible low-income adults and childrenaccess to health and medical coverage through managed care plans. The QUEST program isdesigned to provide Quality care, Universal access, Efficient utilization, Stabilizing costs, andto Transform the way health care is provided to recipients.2Rev. 072820

Applications for Health Care Coverage are accepted: Online at www.mybenefits.hawaii.gov Over the phone at 1-877-628-5076 By mail delivered to Med-QUEST Division eligibility offices Unit AddressRoom Telephone FaxOahu Section801 Dillingham Honolulu HI96817-45823rd Floor587-3521587-3540587-3543Molokai Unit65 Makaena Place Kaunakakai HI96748Room 110553-1758553-3833Kapolei Unit601 Kamokila Boulevard KapoleiHI 96707-2021Room 415692-7364692-7379Kauai Unit4473 Pahee Street Lihue HI96766-2037Suite A241-3575241-3583West Hawaii Section75-5591 Palani Road Kailua-KonaHI 96740-3633Suite 3004327-4970327-4975East Hawaii Section1401 Kilauea Avenue Hilo HI96720933-0339933-0344Lanai Unit730 Lanai Avenue Lanai City HI96763565-7102565-6460Maui Section210 Imi Kala Street Wailuku HI96793-1274243-5780243-5788Suite 101Individual Dental and Vision PlansHawaii Dental Service (HDS) provides Individual Plans for yourself and your family. HDS memberslosing group coverage may enroll in an Individual plan with waiting periods waived. Please call HDSfor details and plan options. Let the representative know you are losing group coverage, provideyour current member ID # and they will provide your eligibility information.For information on how to apply for HDS Individual plans: Please call (808) 529-9248, ask aboutIndividual Plans, or visit hawaiidentalservice.com.HMSA provides Individual Plans for yourself and your family.For information on how to apply for HMSA Individual plans: Please call (808) 948-5555, Prompt:“Health Plans for yourself or your family”, or visit lans/ (hover mouse over “Health Plans” and select “Individuals & Families: DentalPlans”.3Rev. 072820

Ho’ala Dental Individual Plan is a cost-effective program that provides its members with certainprivileges, such as discounted prices on dental services. Participants pay an annual membership feeand are then entitled to a host of discounts and benefits. Their network of providers are located atten convenient centers statewide.For information on how to apply for a Ho’ala Dental Individual plan: Please call (808) 523-3111, orvisit hoaladental.com.Individual Vision PlanVSP Individual Vision Plans are full-service plans that include eye care and eyewear at low monthlyrates for former group members. In addition to care from VSP’s network of independent doctors,Individual Vision Plans also provide access to retail options. For information on how to apply for VSPIndividual plans: Please call 800-785-0699, ask about Individual Plans, or visit vspdirect.com (click on“Find A Vision Plan”)Discount Dental and Vision ProgramsChewsi. No dental insurance? No problem! And we mean it. With Chewsi, you have access to savingson every dental service, every time. When you visit a Chewsi dentist and use the Chewsi app to payfor your care, you’ll save on everything from cleanings, exams and x-rays to fillings, crowns, implantsand dentures. And, you’ll never pay a monthly fee or need a subscription to get your Chewsi savings.Just take your smartphone to any Chewsi dentist, and pay right through the app to save.Visit: chewsidental.com/VSP's Vision Savings Pass offers significant discounts on eye care and eyewear, through VSP networkdoctors and Visionworks locations nationwide. This non-insurance discount program providesguaranteed pricing and discounts and is effective through December 31, 2020. There is no cost forterming employees who had VSP to enroll. To enroll, visit: visionsavingspass.vspforme.com/Discount Drug ProgramsState of Hawaii drug discount program (similar to Medicaid discounts) available through Hawaii RxCard program. All Hawaii residents are eligible to receive a free card.For more information, and to print your ID card visit: hawaiirxcard.com/Walmart offers a 4 co-payment for certain generic prescriptions on their formulary.For more information, visit: walmart.com/cp/4-dollar-prescriptions/1078664, visit the PharmacyDepartment and click on “ 4 Prescriptions”.4Rev. 072820

Walgreens Prescription Savings Club provides discounts on the cash price of brand-name and genericmedications as well as other products and services throughout the store. It is not medical insurance,but it does help you save at the pharmacy. x program offers uninsured patients access to thousands of brand name and genericmedications at a fraction of the cost with our prescription savings card. Download your exclusivesavings card and present it to your pharmacist to save an average of 80%* at over 60,000pharmacies in the U.S. and Puerto Rico, as well as through the Express Scripts Pharmacy for InsideRx. insiderx.com/assistance?source unemployedemailNo Cost and Discounted Insulin ProgramsNovo Nordisk: The Novo Nordisk Patient Assistance Program (PAP) is based on our commitment topeople living with diabetes. The Patient Assistance Program provides medication at no cost to thosewho qualify. Patients who are approved for the PAP may qualify to receive free diabetes medicinefrom Novo Nordisk. There is no registration charge or monthly fee for s-help/pap.htmlEli Lilly: In response to the crisis caused by COVID-19, Eli Lilly and Company is introducing the LillyInsulin Value Program, allowing anyone with commercial insurance and those without insurance atall to fill their monthly prescription of Lilly insulin for 35. The program is effective today and coversmost Lilly insulins including all Humalog (insulin lispro injection 100 units/mL) gh-lillyinsulin-value-programSanofi: Sanofi continues its commitment to helping reduce cost burden for people living withdiabetes with first-ever insulin savings program. Further expansion of the Insulins Valyou SavingsProgram - now people can pay 99 for up to 10 boxes of pens and/or 10 mL vials per m source vanityurl&utm medium redirect&utm campaign valyouNo Cost Specialized Care for ChildrenThe Shriner’s Hospital for Children is a state-of-the-art facility that provides Hawaii’s children withthe best orthopaedic care, neurodevelopmental care, fracture clinic, surgery, physical therapy,occupational therapy, radiology, orthotics and prosthetics workshop and other ancillary services.Children and teens up to age 18 are eligible for care at Shriners Hospitals for Children if there is areasonable possibility they can benefit from the specialized services available. In some cases, caremay be extended to patients age 21. Acceptance is based solely on a child’s medical needs,regardless of the families’ ability to pay.Parents, physicians and other health care providers wishing to make an appointment or refer a child,should call 808-941-4466. shrinershospitalsforchildren.org/honolulu5Rev. 072820

Aloha United Way 211Aloha United Way 211 is Hawaii’s only comprehensive, statewide community information andreferral service. Free and confidential.211 specialists can search through over 4,000 government and nonprofit services and programs tofind the information and resources you need. Requests include finding food, shelter, clothing,financial assistance, childcare, parenting support, elderly care, disability services and more! You mayalso do a direct search of the service categories in our online database. Please visit auw211.org.Aloha United Way COVID-19 Assistance ProgramsWorking with local foundations and businesses, Aloha United Way created the COVID-19 Rent &Utility Assistance Program to provide financial relief quickly to those at risk of losing their home orutility services. Aloha United Way COVID-19 Rent & Utility Assistance City & County of Honolulu – Household Hardship Relief Fund Department of Hawaiian Home Lands – COVID-19 Emergency Rental aui County - Hawaii Emergency Laulima Program (H.E.L.P.)Financial assistance for Maui County residents to pay for essential needs due to a layoff,reduction in hours, or loss of income related to COVID-19. Contact Maui EconomicOpportunity at 808-243-4300 or meoinc.orgCommunity Safety Net Sevices – Medical and DentalSTATEWIDEAloha Medical Missionalohamedicalmission.org/810 N. Vineyard Boulevard, Honolulu HI 96817(808) 847-3400Dental Lifeline Network Hawaiidentallifeline.org/Hawaii6Rev. 072820