Welcome to the online EUTF Supplemental Medical & Prescription Drug Plan Resource Page
This EUTF Supplemental Plan is available for active employees that have medical coverage under a separate non-EUTF sponsored plan. Retirees and HSTA VB members are not eligible for this supplemental plan.
This low-cost plan reimburses participants for eligible out-of-pocket costs that arise from their primary medical and Rx drug plans, such as copayments and coinsurances however reimbursement of deductibles is excluded. This supplemental plan leaves participants with minimal costs for covered services and has the lowest employee share of the premium.
Quick Links
Schedule of Benefits | Exclusions List | Frequently Asked Questions | Submit Online Claim
Helpful EUTF Plan Documents
Plan SummaryPlan Year: 7/1/2023 – 6/30/2024View SummaryPlan Year: 7/1/2022 – 6/30/2023View Summary |
Claim Submission FormSubmit Online ClaimPlan Year: 7/1/2023 – 6/30/2024Download Document
Plan Year: 7/1/2022 – 6/30/2023Download Document |
Exclusions ListView Exclusions List |
Frequently Asked Questions (FAQ)View FAQ’s |
Supplemental Plan DocumentDownload Document |
Supplemental Benefits FlyerDownload Document |
*Authorization to Release PHI FormDownload Document |
Privacy PracticesDownload Document |
Other Insurance FormDownload Form |
*Your one-time authorization allows HMA to release your protected health information (PHI), including making payments and explanation of benefits (EOB), to a person or organization that you choose.
Contact HMA
| Pacific Guardian Tower 1440 Kapiolani Boulevard, Suite 1000 Honolulu, Hawaii 96814
Hours Walk-in Hours: Monday through Friday, 7:30 a.m. – 5 p.m. HST | Oahu: (808) 951-4643
Neighbor Islands: (866) 437-1992 Fax: (808) 951-4620 Web: www.hma-hi.com/eutf |