Hawaii Employer-Union Health Benefits Trust Fund | EUTF Active – Medical/Prescription Drug

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EUTF Active – Medical/Prescription Drug

July 1, 2019 - June 30, 2020

Preferred Provider Organization Plans (PPO)

Plan Type	Description	Benefits Summary
EUTF HMSA 90/10 PPO Plan and CVS Caremark Prescription Drug Plan	Preferred Provider Organization 90/10 Plan Administered by HMSA and CVS Caremark	Summary of Benefits and Coverage HMSA Guide to Benefits Drug Summary of Benefits and Coverage CVS Benefits at a Glance
EUTF HMSA 80/20 PPO Plan and CVS Caremark Prescription Drug Plan	Preferred Provider Organization 80/20 Plan Administered by HMSA and CVS Caremark	Summary of Benefits and Coverage HMSA Guide to Benefits Drug Summary of Benefits and Coverage CVS Benefits at a Glance
EUTF HMSA 75/25 PPO Plan and CVS Caremark Prescription Drug Plan	Preferred Provider Organization 75/25 Plan Administered by HMSA and CVS Caremark	Summary of Benefits and Coverage HMSA Guide to Benefits Drug Summary of Benefits and Coverage CVS Benefits at a Glance

Health Maintenance Organization Plans (HMO)

Plan Type	Description	Benefits Summary
EUTF HMSA HMO Plan and CVS Caremark Prescription Drug Plan	Health Maintenance Organization Plan Administered by HMSA and CVS Caremark	Summary of Benefits and Coverage HMSA Guide to Benefits Drug Summary of Benefits and Coverage CVS Benefits at a Glance
EUTF Kaiser HMO Comprehensive and Prescription Drug Plan	Health Maintenance Organization Comprehensive Plan Administered by Kaiser	Summary of Benefits and Coverage Kaiser Benefits Summary
EUTF Kaiser HMO Standard and Prescription Drug Plan	Health Maintenance Organization Standard Plan Administered by Kaiser	Summary of Benefits and Coverage Kaiser Benefits Summary

Supplemental Plan

Plan Type	Description	Benefits Summary
EUTF HMA Supplemental Plan	Supplemental Plan Administered by HMA	HMA Summary

July 1, 2018 - June 30, 2019

Preferred Provider Organization Plans (PPO)

Plan Type	Description	Benefits Summary
EUTF HMSA 90/10 PPO Plan and CVS Caremark Prescription Drug Plan	Preferred Provider Organization 90/10 Plan Administered by HMSA and CVS Caremark	Summary of Benefits and Coverage HMSA Guide to Benefits Drug Summary of Benefits and Coverage CVS Benefits Summary
EUTF HMSA 80/20 PPO Plan and CVS Caremark Prescription Drug Plan	Preferred Provider Organization 80/20 Plan Administered by HMSA and CVS Caremark	Summary of Benefits and Coverage HMSA Guide to Benefits Drug Summary of Benefits and Coverage CVS Benefits Summary
EUTF HMSA 75/25 PPO Plan and CVS Caremark Prescription Drug Plan	Preferred Provider Organization 75/25 Plan Administered by HMSA and CVS Caremark	Summary of Benefits and Coverage HMSA Guide to Benefits Drug Summary of Benefits and Coverage CVS Benefits Summary

Health Maintenance Organization Plans (HMO)

Plan Type	Description	Benefits Summary
EUTF HMSA HMO Plan and CVS Caremark Prescription Drug Plan	Health Maintenance Organization Plan Administered by HMSA and CVS Caremark	Summary of Benefits and Coverage HMSA Guide to Benefits Drug Summary of Benefits and Coverage CVS Benefits Summary
EUTF Kaiser HMO Comprehensive and Prescription Drug Plan	Health Maintenance Organization Comprehensive Plan Administered by Kaiser	Summary of Benefits and Coverage Kaiser Benefits Summary
EUTF Kaiser HMO Standard and Prescription Drug Plan	Health Maintenance Organization Standard Plan Administered by Kaiser	Summary of Benefits and Coverage Kaiser Benefits Summary

Supplemental Plan

Plan Type	Description	Benefits Summary
EUTF HMA Supplemental Plan	Supplemental Plan Administered by HMA	HMA Summary HMA Site