Read the key rules and benefits directly on this page. Official handbooks are also available for printing and reference.
This page summarizes the Basic Health Plan and the Supplemental Health Plan for quick reading. For official wording and printable copies, see the PDF handbooks below.
Expanded summaries for quick reading. For full benefit tables, exclusions, and official language, use the PDF handbooks.
An optional plan funded by member premiums. It supports access to approved off-island facilities under defined rules, approvals, and exclusions.
| Coverage | Resident | Non-Resident |
|---|---|---|
| Single | $60.00 | $93.00 |
| Member + 1 Dependent | $120.00 | $186.00 |
| Family (max 5 total) | $180.00 | $279.00 |
| Family (6–10 total) | $240.00 | $372.00 |
This is a practical checklist to help members prepare. Exact requirements may vary depending on eligibility category.
Generally, off-island referrals require approval by the Medical Referral Committee. Confirm process and required documents before scheduling.
Supplemental typically pays according to the schedule of benefits up to an annual maximum per person, after deductible and co-payment rules. Transportation is not covered.
Yes, family enrollment options exist. Provide dependent SSN (if applicable), relationship, date of birth, and other required information.
This page is for quick reading. PDFs are the official printable handbooks and contain full benefit tables, definitions, and exclusions.
Preview form for review and printing. Backend submission can be connected later (API / HFIMS).
Official handbooks (PDF) for printing and full benefit tables.
For enrollment, eligibility questions, and coverage guidance.
Demo only (no backend).
