Legal & Plan Documents – Hawaii

Summary of Benefits and Coverage

The health benefits available to you represent a significant component of your compensation package. They also provide important protection for you and your family in the case of illness or injury. The Summary of Benefits and Coverage (SBC) summarizes important benefit plan information in a standard format.

Description of Coverage

The Description of Coverage (DOC) contain important information about the HMAA plan’s coverage, limitations, and exclusions.

Special Enrollment Rights Notice

This is an opportunity for certain individuals to enroll in a group health plan, regardless of the plan’s regular enrollment dates. These opportunities occur when you lose eligibility for other coverage or experience certain life events (marriage, birth, adoption, or placement for adoption).

Special Enrollment Rights Notice

Women’s Health and Cancer Rights Act of 1998

If you are enrolled in a medical plan, certain benefits are available for breast reconstruction in connection with a mastectomy.

Women’s Health and Cancer Rights Notice

Newborns’ and Mothers’ Health Protection Notice

If you are enrolled in medical coverage, this notice contains important information about hospital coverage following newborn delivery.

Newborns’ and Mothers’ Health Protection Notice

Medicare Part D Prescription Drug Notice

If you are eligible for or covered by Medicare, this notice contains important information about prescription coverage under the OSI Restaurant Partners, LLC Health Plan and your options under Medicare’s prescription drug coverage.

Medicare Part D Creditable Coverage Notice

Marketplace Coverage Options Notice

To assist you as you evaluate options for you and your family, this notice provides some basic information about the Marketplace (HealthCare.gov).

Marketplace Coverage Options Notice