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

2. EUTF SUPPLEMENTAL HEALTH PLAN PRESENTATION AGENDA2
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.

3. EUTF SUPPLEMENTAL HEALTH PLAN ADDITIONAL CHANGES3
EUTF SUPPLEMENTAL HEALTH PLAN
ADDITIONAL CHANGES
WHO’S ELIGIBLE?
• Overall plan year maximum benefit of $2, 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.

4. EUTF SUPPLEMENTAL HEALTH PLAN4
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.

5. EUTF SUPPLEMENTAL HEALTH PLAN MEDICAL BENEFITS5
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
This supplemental medical plan is always the secondary payer and exclusions apply.

6. EUTF SUPPLEMENTAL HEALTH PLAN PRESCRIPTION DRUG BENEFITS6
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.

7. 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.

8. 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 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
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.

9. 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 (Walk-in hours: Monday-Friday 7:30 a.m.-5:00 p.m. HST) Oahu: Neighbor Islands: (866) Fax: (808) 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
Contact HMA
HMA is proud to service the EUTF. Plan information can be found online at 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 and toll free from the Neighbor islands at (866)
Mahalo for your time and we look forward to serving you. Aloha!