My Hawaii Wellness

Times Supermarket Documents

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Here you’ll find Times Supermarket documents and forms you will need in Adobe PDF format. Don’t have Adobe Reader? Get it here

Times Health Plan Documents

Summary Plan Description (SPD)

Enhanced Plan 

Comprehensive Plan

Other Notices

Medicare Coverage Disclosure

Mandatory Notice

Prior Authorization List

Downlod PDF

Provider Listing

HMN Directory

Summary of Benefits

Enhanced Plan

Comprehensive Plan 

Summary of Benefits & Coverage (SBC)

Enhanced Plan

Comprehensive Plan 

SBC Glossary

Download PDF

 

Helpful Documents and Forms

HIPAA Authorized Representative Form

Download PDF

Urgent Care Listings

Download PDF

Coordination of Benefits (COB) Questionnaire

Download PDF

Akamai Way Flier

Download PDF

Online Member Portal

Download PDF

Maternity Flier

Download PDF