Plan Changes
All changes effective January 1, 2025, unless otherwise specified
HMSA
- Aligned the benefit maximum for orthodontic treatment of orofacial anomalies with the State-mandated benefit maximum, rounded to the the nearest $10 (from $6,900 to $6,930 in 2025), under the EUTF and HSTA VB retiree plans.
Kaiser Permanente
- Aligned the benefit maximum for orthodontic treatment of orofacial anomalies with the State-mandated benefit maximum (from $6,898 to $6,927 in 2025) under the EUTF and HSTA VB non-Medicare retiree plans.
- Updated the calendar year maximum out-of-pocket (CY MOOP) for Medicare Part D medications to $2,000 per person under the EUTF and HSTA VB KPSA plans, as required by law.
- Decreased the urgent care copay from $20 to $15 under the EUTF and HSTA VB KPSA plans.
- Added 100% coverage of residential hospice under the HSTA VB KPSA plan.
- Removed the lifetime limitation of two elective pregnancy terminations of non-viable fetuses from the EUTF and HSTA VB non-Medicare retiree plans.
Humana
- Addition of 100% coverage of Hawaii Interisland Travel (limited to 10 round-trip tickets per calendar year) under the EUTF Humana Medicare Advantage plan.
CVS Caremark / SilverScript
- Added a $2,000 per person per calendar year maximum out-of-pocket (CY MOOP) to all EUTF and HSTA VB retiree plans. The CY MOOP will apply to specialty and non-specialty drugs.
- Increased the non-preferred brand copays from $30 to $40 for a 30-day supply under the EUTF non-Medicare and Medicare retiree plans. A 90-day supply will continue to be two times the 30-day copay under the EUTF Medicare retiree plan and at a Retail 90 or Mail Order pharmacy under the EUTF non-Medicare retiree plan.
- Changed the out-of-network non-specialty member cost share to a 20% coinsurance under the EUTF Medicare retiree plan and a 30% coinsurance under the HSTA VB Medicare retiree plan.
HDS
- Increased coverage of basic services (e.g., fillings, root canals, gum surgery, oral surgery, and adjunctive general services) from 60% to 80% under the EUTF and HSTA VB retiree dental plans.
- Added a $50 annual deductible per person, per calendar year, on services not covered at 100% (i.e., services other than preventive and diagnostic) under the EUTF and HSTA VB retiree dental plans.