Small business health plans in Hawaii

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Available plan type | Health Maintenance Organization (HMO) Plans | Deductible Health Maintenance Organization (DHMO) Plans | Point of Service (POS) Plans |
What is it? | A plan that covers care from in-network physicians. With predictable costs and no deductibles, you know how much you’ll pay for services and prescriptions. | An HMO plan with a deductible that offers lower rates. Employers and employees share costs. | POS plans are available alongside an HMO or DHMO. Get the convenience of one health plan for all your employee benefits. |
What's the advantage for employers? |
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What’s the advantage for employees? |
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Is there out-of-network coverage? | No (except for emergencies) | No (except for emergencies) | Yes, but at a higher cost |
Annual deductible? | No | Yes | Yes |
Copays? | Yes | Yes | Yes, for most in-network services; most out-of-network services require coinsurance payments |
Is a primary care physician required? | Yes | Yes | No |
Is a referral required to see a specialist? | Usually | Usually | No, but some services require precertification |
Available plan type
:
Health Maintenance Organization (HMO) Plans
What is it?
A plan that covers care from in-network physicians. With predictable costs and no deductibles, you know how much you’ll pay for services and prescriptions.
What's the advantage for employers?
- Comprehensive coverage
- Low, predictable out-of-pocket costs
- User friendly
- Easiest plan to administer
- Highest level of employee satisfaction
What’s the advantage for employees?
- Low out-of-pocket costs
- Care coordinated by a primary care physician
- Easy to understand
- No deductible
- Copay or coinsurance amounts are known up front
- Convenient for budgeting
- Additional payment options
Is there out-of-network coverage?
No (except for emergencies)
Annual deductible?
No
Copays?
Yes
Is a primary care physician required?
Yes
Is a referral required to see a specialist?
Usually
Available plan type
:
Deductible Health Maintenance Organization (DHMO) Plans
What is it?
An HMO plan with a deductible that offers lower rates. Employers and employees share costs.
What's the advantage for employers?
- Lower monthly rates
- Wide range of deductibles, copays, and coinsurance options
What’s the advantage for employees?
- Lower premiums than regular HMO plans
- Care coordinated by a primary care physician
- Preventive services covered at little or no cost
Is there out-of-network coverage?
No (except for emergencies)
Annual deductible?
Yes
Copays?
Yes
Is a primary care physician required?
Yes
Is a referral required to see a specialist?
Usually
Available plan type
:
Point of Service (POS) Plans
What is it?
POS plans are available alongside an HMO or DHMO. Get the convenience of one health plan for all your employee benefits.
What's the advantage for employers?
- Choice, flexibility, and convenience
- Coverage for employees living and working outside our service areas
- Referral-free access to an outside network of doctors and licensed providers
What’s the advantage for employees?
- Broader choice of primary care physicians
- No referrals required for specialists
Is there out-of-network coverage?
Yes, but at a higher cost
Annual deductible?
Yes
Copays?
Yes, for most in-network services; most out-of-network services require coinsurance payments
Is a primary care physician required?
No
Is a referral required to see a specialist?
No, but some services require precertification
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