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Frequently Asked Questions - FAQs
FAQs by Category
General
Benefits
Prescription Drugs
Retirees
Regarding New HMSA
Q&A For VEBA Trust Participants Regarding New HMSA Plan
- Q: Why is VEBA offering HMSA now after we all moved to HMA?
A: Back in May, due to concerns over both large VEBA Trust fund insurance losses and the looming budget crisis, the trustees
decided to offer members a choice between two medical plans – a lower cost HMA plan with no increase to your contribution and
the higher-cost HMSA plan for those who wanted greater benefits and were willing to pay for them.
At the time, HMSA notified us that it was against company policy to offer an HMSA fully-insured plan alongside the HMA VEBA
Trust self-insured plan.
However, HMSA recently made an exception to its policy and is now willing to offer the higher benefit plan (fully-insured
by HMSA) alongside the HMA plan (self-insured by the VEBA Trust), so those members who were previously enrolled in HMSA
may choose to re-enroll.
- Q: Who can enroll in the new HMSA plan?
A: If you were enrolled in the Active (non-retiree) HMSA Primary Medical Plan as of June 30, 2009, you have the option of
moving back to HMSA.
If you wish to continue under the HMA-administered plan, you do not need to take any action.
- Q: How do I enroll in the new HMSA plan?
A: You should receive an enrollment form in the mail by August 26 that you need to complete and mail back. The HSTA VEBA
Trust Office must receive your enrollment form on or before September 21, 2009 for you to be enrolled in the new HMSA plan
effective October 1, 2009.
If you have any questions about the plans or how to enroll, please contact the HSTA VEBA Trust Office at 591-2823 (on Oahu),
or for neighbor islands, call toll free at 1-800-637-4926.
- Q: Did VEBA Trustees cave into pressure from teachers who were upset about HMA replacing HMSA?
A: No. HMSA decided on its own to change its long-standing policy and informed us that they would now allow the HMSA plan
to be offered alongside HMA.
- Q: Is the new HMSA plan the same as the one we had before?
A: The plans are similar; the HMSA plan is a PPO plan that offers 90/10 coverage. However, the cost of the premiums has
increased by 21% for the individual plan and 16% for the family plan; participants are responsible for paying 100% of this
increase. In addition, the hospital and surgery benefit has changed from 100% coverage to 90% coverage.
HMSA is also offering participants several new features which include health education and chronic disease management programs.
Please refer to the letter that was mailed to you for more specific information.
- Q: How will HMSA honor the accumulation to my annual co-payment maximum?
A: Whatever copayments that you had accumulated in the old HMSA plan towards your annual co-pay maximum as of June 30, 2009,
will be carried over to your new enrollment in the new HMSA plan. Any costs incurred from July 1, 2009 through September 30,
2009 will not be recognized by the new HMSA plan as accumulating toward the annual co-pay maximum.
- Q: The HMA Plan is a self-insured plan and the HMSA plan is fully-insured. What does that
mean?
A: A self-insured plan is a plan that an employer or a trust chooses to operate itself, by paying the cost of its employees’
claims plus administrative costs from its own accounts, rather than paying premiums and filing claims through a typical
insurance provider (called a "fully insured plan"). Being self-insured saves on the profit margin that an insurance company
builds into its premium, but it also exposes the company or trust to greater risk if its costs are higher than anticipated.
The HSTA VEBA Trust is self-insured for the Primary Medical 80/20 Benefit Plan and contracts with HMA to process claims. This
is similar to the arrangement that existed with HMSA, the previous claims administrator. By self-insuring, the VEBA Trust
can better manage the plan benefits and more tightly control costs.
HMSA’s fully-insured plan is an option for those who want higher benefits and are willing to pay more for them. The insurance
risk for this fully-insured plan will be shouldered by HMSA, not the VEBA Trust.
- Q: If I switch from HMA to HMSA, how do I know that you won’t stop offering HMSA again in the
future?
A: Since HMSA changed its policy and will now allow the VEBA Trust to offer HMSA alongside HMA, we believe that HMSA is
committed to being an option for our members and that we’ll continue to offer HMSA in the future.
- Q: Why are you only allowing teachers who were with HMSA on June 30 this year to enroll back
into HMSA? Why not all teachers?
A: This is a optional enrollment that is being offered to those teachers previously enrolled in HMSA who were not given the
option to remain with HMSA in June 2009, when VEBA made the transition to HMA.
All Bargaining Unit 5 teachers will have the opportunity to enroll in the new HMSA plan during the next open enrollment,
which the State will announce once contract agreements have been reached.
- Q: We don’t have a contract with the state; if I choose this new HMSA plan, will I lose coverage
or have to pay more?
A: Once negotiations for a collective bargaining agreement are complete, the VEBA trustees will review the benefit package
and make any modifications, if necessary, based on any changes to the contribution amounts negotiated with the State of Hawaii.
You will continue to be covered by the new HMSA plan. However, depending on the outcome of collective bargaining negotiations,
your costs may increase from the current costs.
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