RCUH Open Enrollment FY 2022-2023
| Form | Related Policy/Procedure |
|---|---|
| 1a_RCUH Group Health Enrollment/Change Form (OEB-5H) | 3.520, 3.520A |
| 1b_RCUH Group Health Insurance Waiver Form (OEB-5W) | 3.520 |
| 2_RCUH Flexible Spending Enrollment & Change Form (OEB-5F) | 3.530 |
| 3_RCUH ACA Health Enrollment/Waiver Form (OEB-5A) | 3.520 |
Vendor Presentations
Hawaii Medical Service Association (HMSA) – Medical Benefits
Hawaii Medical Service Association (HMSA) – Prescription, Vision, and Complementary Care Benefits
Kaiser Permanente Medical Benefits (Transcript)
Hawaii Dental Service (HDS) Benefits
National Benefit Services (NBS) Benefits
1) Health Plans: HMSA, Kaiser & HDS
RCUH Monthly Premium Rate Sheet FY 2022-2023
Policy 3.520 RCUH Health Plans
Policy 3.520A Addendum: RCUH Health Plans
Medical: HMSA
HMSA Plan Differences – HMO vs. PPO
Summary of PPO Benefits:
– HMSA Preferred Provider Plan
– HMSA Comprehensive Medical Plan
– HMSA Comprehensive Medical Plan – Basic
Summary of HMO Benefits:
– HMSA Health Plan Hawai’i Plus
– HMSA Health Plan Hawai’i Basic
Medical: Kaiser Permanente
Kaiser Permanente Plan Comparisons
Kaiser Plan A: Summary of Benefits
Kaiser Plan B: Summary of Benefits
Kaiser Transition of Care Form
Dental: Hawaii Dental Service
2) Flexible Spending Plan: NBS
RCUH Flexible Spending Account Overview
National Benefits Services Website
National Benefits Services Web Portal Log-in Information
Policy 3.530 RCUH Flexible Spending Plan
Policy 3.530A Addendum RCUH Flexible Spending Plan
3) Group Life Insurance: MetLife
RCUH Group Life Insurance Summary of Benefits
Policy 3.540 RCUH Group Life Insurance
4) Supplemental Long-Term Care Insurance: UNUM
For more information/assistance, please contact RCUH Benefits at [email protected] or call (808) 956-6979 or (808) 956-7055.