Individual Business Plan – PPO

HMSA’s health plan for sole proprietors strikes a balance between the coverage you need and a cost you can afford. HMSA’s Individual Business Plan-PPO (IBP-PPO) offers broad coverage for medical services, prescription drugs, and vision and dental care. Additionally, HMSA has arranged a $15,000 group-term life and accidental death and dismemberment benefits policy for plan members through Benefit Services of Hawaii, Inc.

There are more good reasons to select HMSA’s IBP-PPO:

  • Access to HealthPass: This program offers a health risk assessment and preventive services to help you identify potential health problems and reduce your health risks.
  • Preferred providers save you money: You have the freedom to choose any physician. For maximum plan benefits, choose an HMSA participating provider.
  • Precertification: Your HMSA plan helps control expenses and includes special features to help you get appropriate health care in the proper setting. Precertification is a process to ensure that certain medical treatments, procedures or devices meet payment determination criteria before services are rendered.

HMSA’s IBP-PPO is medically underwritten and your application is subject to approval. This means that the professional medical underwriters at HMSA and its business associate, Medwise Partners, Inc. (MPI), will review your medical history to determine if you will be offered plan coverage. During the medical underwriting process, HMSA or MPI may request additional information, medical records, and lab tests needed to complete the review.

Upon approval, you will be notified of your plan’s effective date and be billed for your first month’s dues. Because this is a medically underwritten plan and subject to approval, we strongly encourage you to keep any existing health care coverage until your IBP-PPO coverage is confirmed.

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