RCUH Open Enrollment FY 2022-2023

FormRelated 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

HMSA Plan Comparison PPO

HMSA Plan Comparison HMO

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

HDS: Summary of Benefits

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.

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