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HMA Hawaii
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Click on the icon next to a form or document to view, print or download.

Note below that the services provided by acupuncturists, chiropractors and naturopaths listed in the provider directory are not covered benefits for EUTF Participants under the EUTF PPO option.

These documents are in Adobe PDF format. If you have problems viewing these documents, you may need to download and install the free Acrobat reader from Adobe. You can download this program here.


  View Document   Akamai Way Poster 10-Nov-2009 31M  
  View Document   Coordination of Benefits Questionnaire 19-Aug-2009 0.01M  
  View Document   Explanation Of Benefits Sample 19-Aug-2009 0.03M  
  View Document   HIPAA AUTHORIZED REPRESENTATIVE FORM 18-Jan-2010 0.02M  
  View Document   HMA Behavioral Health Treatment Plan 22-Jul-2010 0.38M  
  View Document   Open Enrollment Letter 11-Nov-2009 0.18M  
  View Document   Prior Auth List 02-Nov-2009 0.01M  
  View Document   Prior Authorization Form 19-Mar-2010 0.05M  
  View Document   Provider Directory 30-Aug-2010 0.55M  
  View Document   Provider Nomination Form 19-Aug-2009 0.09M  
  View Document   Summary of Benefits 2009-Active 19-Aug-2009 0.32M  
  View Document   Summary of Benefits 2009-Retiree 19-Aug-2009 0.32M  
  View Document   Summary of Benefits Grid-Active 02-Nov-2009 0.02M  
  View Document   Summary of Benefits Grid-Retiree 02-Nov-2009 0.03M  
  View Document   Transition of Care Form 02-Nov-2009 0.08M  


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