Medical

Overview

At WSP USA, we offer you a broad range of benefits plans and resources to support your health and well-being. Our carefully selected team of benefit carriers offers you reliable service, opportunities to save money, and access to valuable resources. These carriers offer large networks of providers and strong discounts, which means lower out-of-pocket costs for you and your family whenever you receive care.

Eligibility and How to Enroll

Eligibility

If you are a regular full-time or regular part-time employee, you are eligible for all benefit options. Part-time employees must, on average, work 24 hours or more a week to be eligible for WSP USA health benefits. Regular part-time employees who work less than 24 hours a week are generally not eligible for health benefits but remain eligible to participate in the WSP USA Retirement Savings Plan. Temporary employees, including interns, are not eligible for participation in WSP USA benefit plans.

Eligible Dependents

Dependents eligible for coverage in the WSP USA health benefits plans include:

Your legal spouse
Your domestic partner. Domestic partners are two individuals who live together in a long-term relationship of indefinite duration. There must be an exclusive mutual commitment to support each other to the same degree and in the same manner as prescribed by law for married persons.
- Partners are not married concurrently to other persons outside of the domestic partnership
- Have been in a mutually exclusive, committed relationship, and have shared a primary residence for the last twelve (12) months, intending to do so indefinitely
- Meet the age requirements for marriage and are mentally competent to consent to contract
- Are not related by blood to the degree prohibited in a legal marriage
- Are jointly responsible for the common welfare of each other and share financial obligations
Children up to age 26 (includes birth children, stepchildren, legally adopted children, children placed for adoption, foster children and children for whom legal guardianship has been awarded to you or your spouse/domestic partner)
Dependent children, regardless of age, provided they are incapable of self-support due to a mental or physical disability, are fully dependent on you for support as indicated on your federal tax return and are approved by your medical plan to continue coverage past age 26.

All enrolled dependents require proof of verification within 31 days of being added to the coverage. Acceptable verification documents include:

Legal Spouse	Marriage certificate: Marriage Certificate must contain the following: information name of the employee, name of the spouse, the date of marriage and certifier’s signature; OR Joint tax return (municipal, state, or federal) from the most current tax year: Tax return must contain the following information: names of employee and spouse, married indicated on tax form. Please black out financial information and Social Security numbers.
Domestic Partner	State-issued Certificate of Domestic Partnership: The certificate must include the following information: the names of the employee and domestic partner, the date of Certificate, and the Certifier’s signature/official state seal; OR Valid WSP USA Domestic Partner Affidavit: Affidavit must contain the following information: name of the employee, name of your partner, the date and notary signature; AND One of the following documents must accompany the Affidavit or Certificate and they must include: name of the employee, name of the domestic partner, name of institution and date: Joint utility invoicing for at least 12 months Joint mortgage or lease for at least 12 months Joint statement from a bank or financial institution Joint insurance document, such as homeowners, renters, or automobile Valid vehicle registration Federal 1040 or State income tax return from current or previous year
Child(ren)	Birth certificates or notices: Birth certificates or notices must contain the following information: name of the employee, spouse, or domestic partner, name of the child and the date of birth; OR Adoption paperwork: Adoption paperwork must reflect that the child is the child of the employee or spouse and contain the following information: name of the adoptive parent, name of child, notary signature and date; OR Court order: Court order must state that the employee or employee’s spouse is the child’s legal guardian and contain the following information: name of the legal guardian (employee, spouse, or domestic partner), name of the child, notary signature and date; OR Qualified Medical Child Support Order (QMCSO) declaring the employee or the employee’s spouse to be legally responsible for providing health coverage for the child: This must contain: name of the parent, name of the child and date; OR Tax return (municipal, state, or federal) from the most current tax year: Tax return must contain the following information: name of parent and name of the child. Please black out financial information and Social Security numbers. PLUS, IF CHILD IS 26 OR OLDER In addition to satisfying the requirements listed above, children 26 or older must also provide one of the following: Proof of disability: Letter from a physician or signed medical records proving physical or mental disability.

Legal Spouse

Marriage certificate: Marriage Certificate must contain the following: information name of the employee, name of the spouse, the date of marriage and certifier’s signature; OR
Joint tax return (municipal, state, or federal) from the most current tax year: Tax return must contain the following information: names of employee and spouse, married indicated on tax form. Please black out financial information and Social Security numbers.

Domestic Partner

State-issued Certificate of Domestic Partnership: The certificate must include the following information: the names of the employee and domestic partner, the date of Certificate, and the Certifier’s signature/official state seal; OR
Valid WSP USA Domestic Partner Affidavit: Affidavit must contain the following information: name of the employee, name of your partner, the date and notary signature; AND
One of the following documents must accompany the Affidavit or Certificate and they must include: name of the employee, name of the domestic partner, name of institution and date:
- Joint utility invoicing for at least 12 months
- Joint mortgage or lease for at least 12 months
- Joint statement from a bank or financial institution
- Joint insurance document, such as homeowners, renters, or automobile
- Valid vehicle registration
- Federal 1040 or State income tax return from current or previous year

Child(ren)

Birth certificates or notices: Birth certificates or notices must contain the following information: name of the employee, spouse, or domestic partner, name of the child and the date of birth; OR
Adoption paperwork: Adoption paperwork must reflect that the child is the child of the employee or spouse and contain the following information: name of the adoptive parent, name of child, notary signature and date; OR
Court order: Court order must state that the employee or employee’s spouse is the child’s legal guardian and contain the following information: name of the legal guardian (employee, spouse, or domestic partner), name of the child, notary signature and date; OR
Qualified Medical Child Support Order (QMCSO) declaring the employee or the employee’s spouse to be legally responsible for providing health coverage for the child: This must contain: name of the parent, name of the child and date; OR
Tax return (municipal, state, or federal) from the most current tax year: Tax return must contain the following information: name of parent and name of the child. Please black out financial information and Social Security numbers.

PLUS, IF CHILD IS 26 OR OLDER

In addition to satisfying the requirements listed above, children 26 or older must also provide one of the following:
- Proof of disability: Letter from a physician or signed medical records proving physical or mental disability.

How to Enroll

Whether you're a new hire enrolling for the first time, a current employee updating coverage due to a qualifying life event, or enrolling during the annual open enrollment period, you can enroll in your benefits two ways:

Log in to the bswift website. Your login information will be reset for Open Enrollment. Your login details are:

Username: Your WSP USA work email address
Password: The last four digits of your Social Security number

After your initial login, you will be asked to change your password.

Please contact bswift at 844-848-1142, weekdays from 8:00 AM to 8:00 PM, ET., or you can send a secure message or chat through the "Contact Us" page on bswift.

Note: The Open Enrollment period has ended. If you failed to make health benefit elections or made incorrect elections, you will be unable to enroll or change your health benefit plans elections until the next Open Enrollment period, unless you experience a Qualifying Life Event.

Choose Carefully

You cannot change your benefit selections during the plan year unless you have Qualifying Life Event, such as marriage and/or the birth or adoption of a child.

Plan Comparison (Mainland)

Your medical plan options include a range of coverage levels and costs, so you can choose the one that’s best for you and your family. These plans are administered by Aetna. You can enroll as a new hire, during Open Enrollment, or if you have a Qualifying Life Event. To enroll, log into bswift, or call 844-848-1142.

All of our medical plans provide:

Comprehensive, affordable coverage

for a wide range of health care services.

Free in-network preventive care

with services such as annual physicals, recommended immunizations, and routine screenings.

Prescription drug coverage

provided by Express Scripts.

Financial protection

through annual out-of-pocket maximums that limit how much you’ll pay each year.

2024 Medical Plans

Use this interactive side-by-side plan comparison to understand key differences between the plans.

	Aetna Choice POS II Basic HDHP	Aetna Choice POS II Enhanced HDHP	Aetna Choice POS II	Open Access Aetna Select (Closed to New Enrollees)
Calendar Year Deductible (individual/family)
In-Network	$3,000 / $6,000	$1,600 / $3,200	$1,000 / $2,000	$750 / $1,500
Out-of-Network¹	$7,500 / $15,000	$3,750 / $7,500	$2,500 / $5,000	N/A
WSP-Funded HSA Contribution (individual/family)
In-Network	$250/$500	$500 / $1,000	N/A	N/A
Coinsurance (Your Share of Costs)
In-Network	20%²	20%²	20%²	10%²
Out-of-Network¹	40%²	40%²	40%²	N/A
Calendar Year Out-of-Pocket Maximum (individual/family)
In-Network	$5,000 / $10,000³	$4,000 / $8,000	$4,000 / $8,000	$4,000 / $8,000
Out-of-Network¹	$12,500 / $25,000	$10,000 / $20,000	$10,000 / $20,000	N/A
Your Cost for Medical Care (what you pay)
Preventive Care	In-Network - No charge Out-of-Network - 40%²	In-Network - No charge Out-of-Network - 40%²	In-Network - No charge Out-of-Network - 40%²	In-Network Only - No charge
Physician’s Office Visits (primary/specialist⁴)	In-Network - 20%² Out-of-Network - 40%²	In-Network - 20%² Out-of-Network - 40%²	In-Network - 20%² Out-of-Network - 40%²	In-Network Only - $25 copay/ $40 copay
Hospital Inpatient⁵ (physician and hospital charges)	In-Network - 20%² Out-of-Network - 40%²	In-Network - 20%² Out-of-Network - 40%²	In-Network - 20%² Out-of-Network - 40%²	In-Network Only - 10%²
Hospital Outpatient (physician and hospital charges)	In-Network - 20%² Out-of-Network - 40%²	In-Network - 20%² Out-of-Network - 40%²	In-Network - 20%² Out-of-Network - 40%²	In-Network Only - 10%²
Virtual Visits (Teladoc)	In-Network - 20%² Out-of-Network - Not Covered	In-Network - 20%² Out-of-Network - Not Covered	In-Network - $25 copay Out-of-Network - Not Covered	In-Network Only - $25 copay
Minute Clinic	In-Network - 20%² Out-of-Network - Not Covered	In-Network - 20%² Out-of-Network - Not Covered	In-Network - $25 copay Out-of-Network - $25 copay	In-Network Only - $25 copay
Urgent Care	In-Network - 20%² Out-of-Network - 40%²	In-Network - 20%² Out-of-Network - 40%²	In-Network - 20%² Out-of-Network - 40%²	In-Network Only - $40 copay
Emergency Room (no coverage for non-emergency care)	In-Network - 20%² Out-of-Network - 20%²	In-Network - 20%² Out-of-Network - 20%²	In-Network - 20%² Out-of-Network - 20%²	In-Network Only - $75 copay
Diagnostic X-Rays and Labs	In-Network - 20%² Out-of-Network - 40%²	In-Network - 20%² Out-of-Network - 40%²	In-Network - 20%² Out-of-Network - 40%²	In-Network Only - $25 or $40 copay at physician’s office; 10%² at independent lab or hospital
Mental Health/ Substance Abuse	In-Network - 20%²- outpatient 20%²,⁴- inpatient Out-of-Network - 40%²- outpatient 40%²,⁴- inpatient	In-Network - 20%²- outpatient 20%²,⁴- inpatient Out-of-Network - 40%²- outpatient 40%²,⁴- inpatient	In-Network - 20%²- outpatient 20%²,⁴- inpatient Out-of-Network - 40%²- outpatient 40%²,⁴- inpatient	In-Network Only - $25 copay - outpatient 10%²,⁴- inpatient
Extended Care/Skilled Nursing Facility⁵ (90 days per year)	In-Network - 20%² Out-of-Network - 40%²	In-Network - 20%² Out-of-Network - 40%²	In-Network - 20%² Out-of-Network - 40%²	In-Network Only - 10%²
Home Health Care⁵ (120 visits per year)	In-Network - 20%² Out-of-Network - 40%²	In-Network - 20%² Out-of-Network - 40%²	In-Network - 20%² Out-of-Network - 40%²	In-Network Only - 10%²
Hospice⁵	In-Network - 20%² Out-of-Network - 40%²	In-Network - 20%² Out-of-Network - 40%²	In-Network - 20%² Out-of-Network - 40%²	In-Network Only - 10%²
Rehab Services⁶ (50 visits per year)	In-Network - 20%² Out-of-Network - 40%²	In-Network - 20%² Out-of-Network - 40%²	In-Network - 20%² Out-of-Network - 40%²	In-Network Only - 10%²
Chiropractic (30 visits per year)	In-Network - 20%² Out-of-Network - 40%²	In-Network - 20%² Out-of-Network - 40%²	In-Network - 20%² Out-of-Network - 40%²	In-Network Only - $40 copay

¹ All out-of-network services are subject to reasonable and customary limits.
² After deductible.
³ Individual in network out-of-pocket amount will be capped at the ACA maximum ($9,450 in 2024).
⁴ A specialist is any provider other than an internist, family doctor, pediatrician, or OB-GYN.
⁵ Precertification required. Participating (or in-network) providers are generally responsible for obtaining precertification from Aetna before they provide certain services to you. When you choose to receive certain covered services from nonparticipating (or out-of-network) providers, you are responsible for notifying Aetna before you receive these covered services. See noncompliance penalties below.
⁶ Rehab Services include physical, speech or occupational, cardiac and pulmonary therapy.
NONCOMPLIANCE PENALTIES: Benefit reduces to 50% of eligible expenses for certain out-of-network services. These services include inpatient hospitalization, mental/nervous/alcohol/drug confinement, extended care/skilled nursing facility, home health care and hospice.

The amount you pay will depend on which plan you choose and whether you cover just yourself or family members, too. WSP USA shares the cost of medical coverage with you. You pay for medical coverage through deductions from your paycheck.

You can see any medical care provider you want (except for employees enrolled in the Open Access Aetna Select), but you’ll pay less by staying in network. Visit the Aetna website to find an in-network care provider near you.

If you have questions about your benefits, your Optavise Advocate can help! Optavise is a confidential, no-cost member advocacy service that is part of your benefits program. Call 866-253-2273 at any time during the year for help with understanding your coverage options!

Aetna Choice POS II Basic HDHP

The Aetna Choice POS II Basic HDHP plans pair low-contribution, high-deductible coverage with a tax-free Health Savings Account (HSA) that helps you save money and plan -for future medical expenses. This combination gives you more control over your money and rewards you for making healthy, cost-conscious choices.

The Aetna Choice POS II Basic HDHP option has lower contributions and a higher deductible than the Aetna Choice POS II Enhanced HDHP option. With this plan, you can see any provider you wish, but you will pay less when you stay in network. Also, you’ll be eligible to participate in a Health Savings Account (HSA).

As an added bonus, WSP USA will contribute to your HSA — $250 for Employee-only coverage or $500 if you cover dependents. Once you enroll in the HSA, this annual amount will be contributed to your HSA account in equal installments per paycheck throughout the year (employees who are hired or enroll in the Aetna Choice POS II Basic HDHP or Aetna Choice POS II Enhanced HDHP options after January 1 will receive prorated contributions).

How the Aetna Choice POS II Basic HDHP works

You pay the plan premiums from your paycheck to have coverage. When you receive in-network preventive care, you pay nothing — it’s covered in full! If you need non-preventive care, it works like this:

¹ Aggregate deductible and out-of-pocket maximum within family coverage (any member or combination of members may satisfy the “per family” deductible and out-of-pocket maximum).

Aetna Choice POS II Enhanced HDHP

The Aetna Choice POS II Enhanced HDHP offers lower out-of-pocket costs in exchange for slightly higher contributions than the Aetna Choice POS II Basic HDHP making your costs more manageable. With this plan, you will pay less when you see an in-network provider.

Paired with a tax-free Health Savings Account (HSA), you can save money and plan for future medical expenses. As an added bonus, WSP USA will contribute to your HSA — $500 for Employee-only coverage or $1,000 if you cover dependents. This annual contribution will be made to HSA accounts in equal installments per paycheck throughout the year (employees who are hired or enroll in the Aetna Choice POS II Basic HDHP or Aetna Choice POS II Enhanced HDHP options after January 1 will receive prorated contributions).

How the Aetna Choice POS II Enhanced HDHP works

You pay the plan contributions from your paycheck to have coverage. When you receive in-network preventive care, you pay nothing — it’s covered in full!

¹ Aggregate deductible and out-of-pocket maximum within family coverage (any member or combination of members may satisfy the “per family” deductible and out-of-pocket maximum).

Aetna Choice POS II Plan

The Aetna Choice POS II Plan offers lower out-of-pocket costs and deductible for doctor visits and prescriptions in exchange for higher contributions than the HDHP options. With this plan, you will pay less when you choose an in-network provider.

How the Aetna Choice POS II Plan works

You pay the plan contributions from your paycheck to have coverage. When you receive in-network preventive care, you pay nothing — it’s covered in full! If you need non-preventive care, it works like this:

Open Access Aetna Select Plan (closed to new enrollees)

The Open Access Aetna Select Plan provides coverage only when you receive care from providers within the Open Access Aetna Select Plan network. Out-of-Network care is not a covered expense.

How the Open Access Aetna Select Plan (closed to new enrollees) works

You pay the plan contributions from your paycheck to have coverage. When you receive in-network preventive care, you pay nothing — it’s covered in full! If you need non-preventive care, it works like this:

Helpful Healthcare Resources

Member Advocacy

Optavise serves as your single resource and member advocate for all benefit-related questions and enrollment assistance. Optavise can help you resolve claim and billing issues, determine potential out-of-pocket costs and seek referrals for second opinions. Optavise can also assist with the following:

Verifying eligibility and understanding your coverage options
Explaining and answering questions on how your benefits work
Locating insurance carrier information (i.e., ID cards)
Finding in-network providers and scheduling appointments
Comparing pricing for an upcoming test, procedure or prescription drugs
Resolving billing and claim issues
Navigating the Qualified Life Event process

You can contact an Optavise Advocate at 866-253-2273, Monday to Friday 8 AM to 9 PM ET. You can also get support via email at wspassistance@optavise.com.

Medicare Assistance Services

Medicare Assistance Services, provided by HTA, gives you all you need to transition to Medicare, acquire the best secondary coverage and obtain ongoing support. HTA’s licensed counselors can explain the Medicare enrollment process and the Medicare claims systems, so you know what to expect. You can contact HTA for a free consultation, which will be followed by a detailed summary email and report outlining your specific “action plan” based on your health needs and situation. There is no cost for this service – you pay the same price for the insurance products through HTA as you would by going directly to the insurance companies.

To contact Medicare Assistance Services, call 610-430-6650, Monday to Thursday 9 AM to 5 PM or Friday 9 AM to 4 PM ET; you can also schedule a consultation via email at medicare@htafinancial.com.

Save money and time by seeking care through Virtual Visits (Teladoc) or an urgent care clinic for non-life-threatening conditions. Visit https://www.aetnaresource.com/n/wsp to find a participating urgent care center near you.

If you have questions about managing an ER stay, your Optavise Advocate can help! Call 866-253-2273 at any time during the year for help resolving claims or finding in-network practitioners!

Virtual Visits (Teladoc) can also be used for dermatology related consultations and treatment, and mental health counseling! You can provide details (and photos) about skin conditions, such as psoriasis and infections, receive counsel and necessary prescriptions within 2 business days, and schedule follow-ups. If you need mental health support for issues including anxiety, depression, or stress, Teladoc mental health counseling can connect you with a professional therapist seven days a week right from your home.

Aetna Resources & Programs

Your Aetna medical plan offers many resources and programs to help you and your dependents manage your health, along with discounts to make taking care of your well-being more affordable.

Select from the different drop down menus below to find the programs or resources to best suit your needs:

Aetna Autism Advocate: If a family member is diagnosed with autism, use this advocate to answer your questions, pair you with professionals and connect you with support, including applied behavior analysis (ABA) therapy. Contact Aetna Autism Advocate at 1-866-724-0604 (TTY: 711) and select Option 5.
Transgender Advocates: Advocates provide education, support and resources:
- Understand and access benefits
- Support throughout gender affirmation surgery process
- Referral to online resources and local community support
- Find providers and facilities specialized in transgender care
- Focus on the physical and mental well-being
Aetna Enhanced Maternity Program: This program provides support wherever you are on your journey: family planning and fertility through post-partum care. And if you're already expecting a baby, you'll get the special attention you deserve. Aetna is here to offer plenty of support for a healthy pregnancy, along with extra help for at-risk pregnancies. All you have to do is sign up if you are enrolled in WSP USA’s medical plan — there’s no additional cost to you. Log in to https://www.aetnaresource.com/n/wsp and look under "Health & Wellness" or call 800-CRADLE-1 (272 3531) weekdays, 8 AM to 7 PM ET.
Health Condition Management: If you are managing a chronic condition or facing a new diagnosis, an Aetna nurse may reach out to offer support. This personal assistance is available at no extra cost and is designed to help you make informed decisions and achieve optimal results from your treatment.
Transform Oncology: This comprehensive, connected approach to managing cancer connects you with a personal navigator who will work with you one-on-one to address your needs, such as finding quality care, getting services approved, managing treatment side effects, understanding your benefits and more. It includes the Guided Genetic Health^® program offers genetic counseling and testing to guide your treatment and assess your risk of developing other forms of cancer. You also have access to the online Aetna Cancer Support Center, serving as your trusted source for information and guidance on what to expect while managing cancer treatment and care. Log in or text CancerCare to 66902 for a link. If you’ve been diagnosed with cancer, an Aetna nurse may reach out to you. Or you can call your Aetna Concierge at 866-267-1454 (TTY: 711) to learn more.
Aetna Kidney Support: Aetna Kidney Support uses predictive technology to determine members of progression of chronic kidney disease and delay progression to dialysis treatment. Aetna Kidney Support provides members with chronic kidney disease education and support designed to help delay the onset of end-stage renal disease (ESRD). Contact Aetna at 866-267-1454 (TTY: 711) for more information.

When you enroll in the Aetna Enhanced Maternity Program, you will receive a Bump Box with baby supplies to get you started!

Plan Comparison (Hawaii)

If your work location is Hawaii, medical and pharmacy benefits are offered through either HMSA or Kaiser Permanente. You have two plan options to choose from:

HMSA PPO Plan: You pay higher premiums, but are covered by both in- and out-of-network providers.
Kaiser Permanente HMO Plan: You pay lower premiums, but your provider network is limited and out-of-network coverage is available for emergencies only.

The Hawaii medical plan options allow you to choose a plan that will best help you and your family enjoy the benefits of good health. It is up to you to choose the plan that best matches your needs. Your medical plan will remain in place through the year unless you have a Qualifying Life Event.

Use this interactive side-by-side plan comparison to understand key differences between the plans.

	HMSA PPO	Kaiser Permanente HMO
Calendar Year Deductible (individual/family)
In-Network	None	None
Out-of-Network	None	N/A
Calendar Year Out-of-PocketMaximum (individual/family)
In-Network	$2,500 / $7,500	$2,500 / $7,500
Out-of-Network	None	N/A
Your Cost for Medical Care (what you pay)
Preventive Care	In-Network - No charge Out-of-Network - No charge	In-Network Only - No charge
Physician’s Office Visits (primary/specialist)	In-Network - $14 copay Out-of-Network - $14 copay	In-Network Only - $15 copay
Hospital Inpatient (physician and hospital charges)	In-Network - Facility – 20% Physician - $20 copay Out-of-Network - Facility – 20% Physician - $20 copay	In-Network Only - $75 per day
Hospital Outpatient (physician and hospital charges)	In-Network - Facility – 20% Physician - $20 copay Out-of-Network - Facility – 20% Physician - $20 copay	In-Network Only - $15 copay
Urgent Care	In-Network - $14 copay Out-of-Network - $14 copay	In-Network Only - $15 copay; 20% out-of-area
Emergency Room (no coverage for non-emergency care)	In-Network - 20% Out-of-Network - 20%	In-Network Only - $75 copay
Air/Ground Transportation	In-Network - 20% Out-of-Network - 20%	In-Network Only - 20%
Diagnostic X-Rays and Labs	In-Network - 20% (no charge for lab tests) Out-of-Network - 20%	In-Network Only - 10%
Mental Health/ Substance Abuse	In-Network - Inpatient - 20% Outpatient facility - 20% Outpatient physician - $14 copay Out-of-Network - Inpatient - 20% Outpatient facility - 20% Outpatient physician - $14 copay	In-Network Only - Inpatient - $75 per day Outpatient - $15 copay
Extended Care/Skilled Nursing Facility (120 days per year)	In-Network - 20% Out-of-Network - 20%	In-Network Only - No charge
Home Health Care (120 visits per year)	In-Network - 20% Out-of-Network - 20%	In-Network Only - No charge
Durable Equipment	In-Network - 20% Out-of-Network - 20%	In-Network Only - Diabetes equipment – 50% All other equipment – 20%
Hospice	In-Network - No charge Out-of-Network - No charge	In-Network Only - No charge
Rehab Services	In-Network - 20% Out-of-Network - 20%	In-Network Only - Inpatient - $75 per day Outpatient - $15 copay

NOTE: All out-of-network services are subject to reasonable and customary limits. Please note: The Kaiser Permanente HMO Plan provides coverage for in-network care only. If you go to an out-of-network provider or facility, your costs will not be covered (except in cases of true emergency).

You pay for medical coverage through deductions from your paycheck.

HMSA PPO

The HMSO PPO Plan gives you the freedom to use in- and out-of-network providers. However, in-network providers have agreed to lower fees, which helps keep money in your pocket. If you choose to use out-of-network providers, your Plan costs will be higher.

Plan overview

With the plan, you receive:

Free in-network preventive care
Coverage for both in- and out-of-network care
Copays for prescription drugs and office visits only
Coinsurance for most services
No deductible
You can contribute tax-free money to a Health Care Flexible Spending Account (HCFSA) to pay your current year’s expenses.

Resources and Programs

HMSA offers many resources and programs to help you manage your health and your care, along with discounts to make taking care of your well-being more affordable.

Kaiser Permanente HMO

The Kaiser Permanente HMO plan provides coverage for in-network services only. If you choose to go out-of-network in the Kaiser Permanente HMO Plan, you will be responsible for 100% of the cost (unless for true emergencies). Prescription drugs are embedded into your coverage. Your primary care provider (PCP) will coordinate your care to help manage costs.

Plan overview

With the plan, you receive:

Free in-network preventive care
Coverage for in-network care: out-of-network coverage available for emergencies only
Your care must be coordinated by a primary care physician
Copays for most services and prescription drugs
No deductible
You can contribute tax-free money to a Health Care Flexible Spending Account (HCFSA) to pay your current year’s expenses.

The plan requires you to select a primary care provider (PCP) who will manage your care and provide referrals if you need to see a specialist. Visit https://www.kp.org or call 808-432-5955 (Oahu) or 800-966-5955 (Neighbor Islands).

Resources and programs

Kaiser Permanente offers many resources and programs to help you manage your health and your care, along with discounts to make taking care of your well-being more affordable.

Kaiser Permanente Resources and Programs

Scroll down to view a selection of programs to find the one that best matches your current needs:

Employee Premiums

You can rest assured in our continued commitment to offer quality, affordable benefits to help you and your family live well. Please refer to the 2024 rate tables below to help you compare and choose benefits.

MEDICAL/PHARMACY PLAN BIWEEKLY PREMIUMS (PRETAX)

	Aetna Choice POS II Basic HDHP	Aetna Choice POS II Enhanced HDHP	Aetna Choice POS II Plan	Open Access Aetna Select Plan (closed to new enrollees)
Employee Only	$66.24	$73.35	$117.06	$160.53
Employee + Spouse/Domestic Partner*	$146.47	$162.19	$258.37	$354.12
Employee + Children	$123.16	$136.38	$217.28	$297.80
Employee + Family	$207.11	$229.34	$364.90	$499.95

HAWAII MEDICAL/PHARMACY PLAN BIWEEKLY PREMIUMS (PRETAX)

	HMSA PPO	Kaiser Permanente HMO
Employee Only	$24.66	$24.66
Employee + Spouse/Domestic Partner*	$383.43	$164.74
Employee + Children	$319.52	$148.26
Employee + Family	$556.87	$247.09

* Premiums for domestic partners and their eligible dependents are subject to applicable IRS regulations with after-tax deductions and imputed income.