PPO Documents & Forms

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Here you’ll find the HI Teamsters PPO Documents and forms you need in Adobe PDF format. Don’t have Adobe Reader? Get it here

Hawaii Teamsters PPO Health Plan Documents

Summary of Benefits & Coverage (SBC)

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SBC Glossary

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Plan Documents (Active)

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Plan Documents (Retirees)

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Prior Authorization List

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PPO Provider Directory

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Helpful Documents and Forms

HIPAA Authorized Representative Form

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Urgent Care Listings

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Coordination of Benefits (COB) Questionnaire

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Akamai Way Flier

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Frequently Asked Questions (FAQ’s)

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