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Health Insurance Information

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Hawaii Health Insurance

 

All health insurance policies in Hawaii are considered guaranteed renewable as long as your premiums are paid up to date.  So this means your health insurance can not be canceled because you become sick.

 

Hawaii mandates that health insurance companies cover newborns and adopted children for the first 31 days, on their parent’s policy.  But inversely pregnancy is, and can be considered a pre-existing condition, except on group health policies.  Pregnancy is a pre-existing condition but not on group health insurance.

 

If you are looking for additional information the Hawaii Division of Insurance is a great place to look.  You can visit them directly here.

 

                               Request a Hawaii Health Insurance Quote

 

Hawaii Small Business Health Insurance

 

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Unlike other states, Hawaii requires all small businesses to offer health insurance to their employees as long as the employee meets certain requirements.  These requirements are; you must work for 20 hours/week for 4 consecutive weeks.  If these requirements are met, the employer must pay at least 50% of their employee’s health insurance premiums.

 

In Hawaii, a group health plan, can not base your health insurance premiums on your health.  This is called non discrimination.  Small Business Health Insurance in

Hawaii is also guaranteed issue, meaning that you can not be turn down for coverage.   In Hawaii, a small business health insurance plan can have no pre-existing clauses!

 

For additional information about Small Business Health Insurance in Hawaii click here.

 

                              Request a Hawaii Small Business Health Insurance Quote

 

 

Hawaii Individual Health Insurance

 

All Hawaii Health Insurance Policies have to cover disabled children on their parent’s policy into their adulthood.  The same regulation applies to the first 31 days of a newborn baby’s life.

 

In Hawaii, insurance companies are able to decide if they want to insure you or not.  They can either rate you up or just refuse coverage.  What you get for coverage is dependant upon what you buy, so look over your policy carefully.

 

If you are HIPAA eligible individual, living in Hawaii, there can be no pre-existing conditions or elimination periods on your individual health insurance policy. 

 

If you are not HIPAA eligible then Hawaii allows health insurance companies to include pre-existing conditions and these are the ways they can do that.   First with an Elimination rider added to the policy, which will deny all claims for pre-existing conditions.  And secondly with an pre-existing condition clause which can not last longer than 36 months.

 

Relative to Pre-Existing Conditions, Insurance companies in Hawaii must give credit to prior credible coverage as long as there was not more than a 63 day lapse in coverage.  Pregnancy is considered pre-existing but genetic information is not.

 

The rates that an individual pays for an Hawaii Health Insurance Plan are based on age, location, health history, family size, sex etc.  Sadly there is no limit on how much an insurance company can charge and individual for coverage.

 

QUEST is a program started by the State of Hawaii to insure lower income residents.  If you think you might qualify, or would like more information visit Quest.

 

For additional information about Individual Health Insurance in Hawaii click here.

 

                              Request a Hawaii Individual Health Insurance Quote

 

 

Hawaii Self Employed Health Insurance

 

In Hawaii, self employed individuals are not allowed to purchase small business health insurance.  Self Employed people in Hawaii are treated as individuals and therefore are subject to the laws and regulations affecting individual health insurance in Hawaii.

 

Another option for affordable Hawaii Self Employed Health Insurance is often associations or self employed groups.  Just keep in mind that not all of these groups, or associations are regulated by the state.

 

One benefit for Self Employed people is that they are able to deduct 100% of their health insurance premiums from their taxes!

 

For additional information about Self Employed Health Insurance in Hawaii click here.

 

                              Request a Hawaii Self Employed Health Insurance Quote

 

 

Temporary Hawaii Health Insurance

 

Many situations may arise where you find yourself without health insurance, or about to be without health insurance.  These reasons could range from graduating college to being in-between jobs.  Instead of going without health insurance you should look into getting a Hawaii Temporary Health Insurance Policy.  These policies will be cheap, with high deductibles and low coverage, but getting a Hawaii Temporary Health Insurance Policy is much better than going with out health insurance.

 

It is important to be aware of the fact that Hawaii Temporary Health Insurance is not guaranteed renewable!  This means that when you reapply, the insurance company can deny coverage, or drastically increase your premiums for the same coverage.

 

For additional information about Temporary Health Insurance in Hawaii click here.

 

                              Request a Hawaii Temporary Health Insurance Quote                          

 

 

What types of Hawaii Health Insurance are there?

 

HMO- Health Maintenance Organization.  This type of insurance is called managed care.  This means you have certain network of doctors and hospitals in Hawaii that you have to go to for care.  Most Hawaii HMO’s have office visit co-payments that range from $10 to $35, and hospital deductibles that range from $250 to $1,500.  Often the most affordable health insurance plans are HMO’s due to the fact they are managed care.

 

PPO-Preferred Provider Organization.  This type of insurance is also called managed care but it gives the consumer much more freedom; they allow you to visit any doctor or hospital in or out of network.  Most Hawaii PPO’s have an in network and an out of network charge.  If the in network co-insurance is 100% then the out of network co-insurance would be 80%.  If the in network co-insurance is 90% then the out of network co-insurance would be 70%   Typically Hawaii PPO’s offer co-payments for doctor visits as well as hospitalization. 

 

Indemnity Plan - In Hawaii, as health insurance rates continue to rise, many people are finding it more affordable to drop their health insurance and buy a Hawaii Major Medical Health Insurance Plan.  An Indemnity plan can also be called a major medical plan or catastrophic health insurance.  Whatever you call it, typically an Hawaii Indemnity Plan would cover more “major” claims.  An Indemnity plan has an annual deductible and will usually allow you to pick different co-insurance options.  Indemnity plans allow you access to any doctor or hospital, and for this reason they are typically very expensive.

 

Discount Medical Plans – In recent years many Discount Medical Plans have started to surface.  These plans have relatively inexpensive, but consumers must realize that this is not insurance.  All these companies do is to get their customers discounted rates (20-50% off) on certain procedures at certain physicians and hospitals. 

 

Federal Mandated Health Insurance Laws

 

HIPAA

Along with Hawaii Health Insurance Laws, there are Federal Laws that regulate Health Insurance companies.   HIPAA (Health Insurance Portability and Accountability Act of 1996). This act mandated federal standards for individual and group health insurance plans.  Some of the standards that it established were relative to guaranteed renew ability, crediting for prior health coverage and pre-existing condition waiting periods.

 

ERISA

Large corporations do not have health insurance policies.  Typically they are self funded, meaning the corporation pays for all of their employee’s medical bills instead of buying health insurance.  Most of these “self funded” companies are regulated by the federal government under ERISA (Employee Retirement Income Security Act)

 

COBRA

In Hawaii it is mandated, by the state, that all companies that offer a Hawaii Group Health Insurance Policy must also enable their employees to extend their health coverage temporarily; called Cobra.  A Hawaii Cobra Insurance is typically available for a time period under 36 months.   In Hawaii you are given 60 days to decide if you are going to take Hawaii Cobra Insurance or not.  Once you have passed on the opportunity to take Cobra, you are not eligible to receive it.

 

Cobra Insurance was introduced in 1985.  Cobra stands for Consolidated Omnibus Budget Reconciliation Act.  If you would like more information about your Cobra Insurance options please contact your companies HR department.

 

Often employees are surprised at the cost of a Hawaii Cobra Insurance.  The reason for this is that they are now responsible for 103% (100% of the premium plus a 3% administration fee) of a monthly health insurance premium when they probably only paid 20% while employed. 

 

Whether nor not to take Cobra is an important question, and you should realize there are alternatives to a Hawaii Cobra Insurance Policy.  One should realize what they plan to do in the future.  If you are looking for another job, and it will be a few months before you get a job, it might make sense to look for a Hawaii Temporary Health Insurance Plan.  If you are contemplating working at a consultant, it would be in your best interest to look into a Hawaii Self Employed Health Insurance Policy.   

 

 

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