FOR ACTIVE EUTF EMPLOYEES EUTF BENEFITS FOR ACTIVE EUTF EMPLOYEES Supplemental Medical & Prescription Drug Plan Welcome to the 2018-2019 presentation for the EUTF Supplemental Medical & Prescription Drug Plan for EUTF active employees. 2018-2019 PLAN YEAR

EUTF SUPPLEMENTAL HEALTH PLAN PRESENTATION AGENDA 2 EUTF SUPPLEMENTAL HEALTH PLAN PRESENTATION AGENDA • PLAN CHANGES • WHO IS ELIGIBLE? • PLAN ADVANTAGES • MEDICAL BENEFITS • PRESCRIPTION DRUG BENEFITS • REIMBURSEMENT INFORMATION • FILING A CLAIM • CONTACT HMA PLAN CHANGES Beginning July 1st, 2018, HMA will administer the EUTF Supplemental Medical & Prescription Drug Plan. HMA will provide all customer service and claims management for this plan. Please Note: All claims for services rendered prior to July 1st, 2018 need to be submitted directly to the previous carrier, Royal State National. In this presentation, we will cover a variety of subjects starting with plan changes.   Beginning July 1st, 2018, HMA will administer the EUTF Supplemental Medical & Prescription Drug Plan. HMA will provide all customer service and claims management for this supplemental plan. Please note: All claims for services rendered prior to July 1st, 2018 need to be submitted directly to the previous carrier, Royal State National.

EUTF SUPPLEMENTAL HEALTH PLAN ADDITIONAL CHANGES 3 EUTF SUPPLEMENTAL HEALTH PLAN ADDITIONAL CHANGES WHO’S ELIGIBLE? • Overall plan year maximum benefit of $2,750 per participant which includes a $250 sublimit maximum for prescription drug copayments. • Chiropractic benefits are no longer covered. • Monthly employee contributions have been reduced. THE EUTF Supplemental Medical & Prescription Drug plan is available to active employees that have medical coverage under a separate non-EUTF sponsored plan. Retirees, HSTA VB members, Medicare and Med-Quest participants are not eligible for this plan. Please Note: If you are currently enrolled in the EUTF Supplemental Medical & Prescription Drug plan then you don’t need to do anything to remain enrolled for the next plan year starting July 1, 2018. Additional changes include an overall plan year maximum of $2,750 per participant, which includes a $250 sublimit maximum for prescription drug copayments.   Benefit does not include reimbursement for deductible(s). Chiropractic benefits are no longer covered. Most importantly, the monthly employees’ contributions have been reduced! Who is Eligible? The EUTF Supplemental Medical & Prescription Drug plan is available for active employees that have medical coverage under a separate non EUTF sponsored plan. Retirees, HSTA VB members, Medicare and Med-QUEST participants are not eligible for this supplemental plan. Please Note: If you are currently enrolled in the EUTF Supplemental plan, no further action is necessary to remain enrolled for the next plan year starting July 1, 2018.

EUTF SUPPLEMENTAL HEALTH PLAN 4 EUTF SUPPLEMENTAL HEALTH PLAN PLAN ADVANTAGES This supplemental plan is beneficial for any active employee who has access to medical and/or prescription drug insurance through a non-EUTF plan.   This low-cost plan reimburses you for eligible out-of-pocket costs from your primary medical and prescription drug plan such as copayments and coinsurance. This supplemental plan leaves participants with minimal out-of-pocket costs for covered medical and prescription drug services. Plan Advantages This supplemental plan is beneficial for any active employees who access their medical insurance through a non EUTF medical plan.   This low-cost plan reimburses participants for eligible out-of-pocket costs that arise from your primary medical and prescription drug plans, such as copayments and coinsurances. This supplemental plan leaves participants with minimal out-of-pocket costs for covered services and has the lowest employee share of the premium.

EUTF SUPPLEMENTAL HEALTH PLAN MEDICAL BENEFITS 5 EUTF SUPPLEMENTAL HEALTH PLAN PREVENTIVE SERVICES • Newborn and well-baby care • Immunizations • One routine office visit • Routine well-woman exam • Routine pap smear • Routine mammogram • Prostate screening • Colorectal Screening PHYSICIAN SERVICES MEDICAL BENEFITS • Office and hospital visits • Emergency room • Routine obstetrical services • Surgeon & assistant • Anesthesia • Physician Assistants & Nurse Midwives OVERALL BENEFIT MAXIMUM: $2,750 per participant per plan year HOSPITAL & FACILITY SERVICES • Ambulatory surgical center • Emergency room • Outpatient hospital ancillary • Inpatient hospital room and board • Inpatient anesthesia • Skilled nursing facility • Birthing center Key Notes • Secondary Payer • Some Exclusions Apply TESTING & OTHER SERVICES • Allergy Testing • Ambulance • Appliances and braces • Behavioral health services • Cardiac Rehabilitation (short-term) • Chemotherapy & Radiation therapy • Diagnostic laboratory & pathology • Dialysis and related supplies • Durable medical equipment • Home therapies • Hospice care • Inhalation therapy • Injections • Physical therapy • Prosthetics • Speech therapy • Tissue and organ transplants Medical Benefits The overall benefit maximum is $2,750 per participant per plan year.   Covered medical services include preventive, physician, hospital and facility, testing, labs and other services including dialysis, chemotherapy and injections. For a full list of covered expenses, please visit www.hma-hi.com/eutf. This supplemental medical plan is always the secondary payer and exclusions apply.

EUTF SUPPLEMENTAL HEALTH PLAN PRESCRIPTION DRUG BENEFITS 6 EUTF SUPPLEMENTAL HEALTH PLAN $20 Per Prescription (per 30-day supply) PRESCRIPTION DRUG BENEFITS Key Notes • Secondary Payer • Some Exclusions Apply Prescription Drug Sublimit (per Plan Year) Per Participant: $250 The Prescription Drug sublimit is applied to the overall $2,750 plan year benefit maximum. Prescription Drug Benefits The Prescription Drug benefit reimburses copayments up to $20 per 30-day supply.   The Prescription Drug sublimit maximum is $250 per participant per plan year and is applied to the overall $2,750 benefit maximum. Like the medical benefits, this supplemental plan is always the secondary payer and exclusions apply.

EUTF SUPPLEMENTAL HEALTH PLAN Plan Reimburses Participants for: 7 EUTF SUPPLEMENTAL HEALTH PLAN Plan Reimburses Participants for: REIMBURSEMENT INFORMATION Eligible out-of-pocket copayments or coinsurance on medical, hospital, physician, surgical and prescription drug expenses. This plan excludes reimbursement of deductibles. After your primary non-EUTF medical plan pays their portion, this supplemental plan reimburses participants for eligible out-of-pocket expenses. Reimbursement Information After your primary non EUTF medical plan pays its portion, this supplemental plan reimburses participants for eligible out-of-pocket expenses. This includes medical, hospital, physician, surgical and prescription drug expenses.

EUTF SUPPLEMENTAL HEALTH PLAN Process to file a claim: FILING A CLAIM 1. Complete a Claim Form The Claim Form can be completed securely online at www.hma-hi.com/eutf. Forms can also be downloaded, completed and mailed or faxed directly to HMA. Key Notes • Copies of EOB’s and receipts are accepted • All reimbursement payments are payable directly to the covered participant 2. Attach the primary health plans Explanation of Benefits (EOB) or copayment receipt. Be sure to attach a copy of the EOB or receipt(s) when completing the claim form online or submitting the claim form by mail or fax. Filing a Claim Claims can be completed and submitted securely online at www.hma-hi.com/eutf.   Paper Claims may also be completed and mailed or faxed directly to HMA. All claim submissions must attach an explanation of benefits (EOB) or copayment receipt. All reimbursement checks are made payable to the covered participant.

EUTF SUPPLEMENTAL HEALTH PLAN CONTACT HMA HMA is proud to serve the EUTF Supplemental Medical & Prescription Drug Plan Hawaii Mainland Administrators 1440 Kapiolani Boulevard, Suite 1020 Honolulu, Hawaii 96814 (Walk-in hours: Monday-Friday 7:30 a.m.-5:00 p.m. HST) Oahu: 951-4643 Neighbor Islands: (866) 437-1992 Fax: (808) 951-4620 Hours: Monday-Friday 7:30 a.m.-7:00 p.m. HST Saturday 9:00 a.m.-1:00 p.m. HST Plan information and other important documents for the EUTF Supplemental Medical & Prescription Drug plan are available online at www.HMA-HI.com/EUTF Contact HMA HMA is proud to service the EUTF. Plan information can be found online at www.hma-hi.com/eutf. HMA’s office is located at 1440 Kapiolani Boulevard, Suite 1020 across from Ala Moana Shopping Center.   You can also reach us on Oahu at 951-4643 and toll free from the Neighbor islands at (866) 437-1992. Mahalo for your time and we look forward to serving you. Aloha!