Understanding Hawaii Health Insurance Exchange

Hawaii has its own health insurance exchange, which is a marketplace where individuals and families can shop for and enroll in health insurance plans.

The exchange is called Hawaii Health Connector, and it's a state-run marketplace that offers a range of plans from different insurance companies.

These plans are designed to meet the needs of Hawaii residents, with coverage for essential health benefits like doctor visits, hospital stays, and prescription medications.

The exchange is open for enrollment during specific periods, usually November to December for the upcoming year, and January to March for special enrollment periods.

The Hawaii health insurance exchange is an online marketplace where individuals and small businesses can shop and compare health insurance choices. It's a one-stop shop to find the right coverage for you and your family.

The exchange is available through HealthCare.gov, making it easy to navigate and understand. You can explore different health insurance options and find out which ones fit your budget and needs.

Individuals seeking health coverage through the exchange will find out if they're eligible for tax credits and subsidies. These can significantly lower the cost of health coverage for those who meet income requirements and don't have health insurance from an employer or a government program.

The tax credits will be immediately applied to your insurance premium, reducing the amount you pay each month. This can be a huge relief for those who are struggling to afford health insurance.

Here's a quick rundown of the tax credit eligibility criteria:

Small businesses with 100 or fewer full-time employees can also take advantage of the Hawaii health insurance exchange. The SHOP (Small Business Health Options Program) is designed to provide affordable health coverage options for small businesses.

The Hawaii Health Insurance Exchange is a marketplace where individuals and families can compare and enroll in health insurance plans. It's a convenient way to find coverage that fits your budget and needs.

The exchange offers a range of plans from different insurance companies, including HMA, HMSA, and AlohaCare. You can browse plans by price, provider network, and other factors to find the best fit for you.

To enroll in a plan, you'll need to provide some basic information, such as your income, family size, and age. This will help determine your eligibility for subsidies and other discounts.

Hawaii's health insurance exchange was formed through a series of legislative actions. Governor Neil Abercrombie signed SB 1348 into law on July 11, 2011, establishing the Hawaii Health Connector.

This law built on the Prepaid Health Care Act of 1975, which required nearly all employers to provide health insurance to employees working 20 or more hours a week for four consecutive weeks.

The Hawaii Health Connector was established as a non-profit corporation, setting it apart from other exchanges.

In order to establish the exchange, Hawaii received conditional approval from the U.S. Department of Health and Human Services on January 3, 2013.

Unfortunately, technical and administrative difficulties led to Hawaii defaulting back to the Federal Health Insurance Marketplace in 2015.

Navigators are here to help you navigate the process of purchasing health insurance or seeking Medicaid qualification. They'll be available across Hawaii to assist individuals and small businesses in making informed decisions.

You can expect navigators to be available to assist with accessing the website, which is a great resource for comparing plans and enrolling in coverage. The Hawaii Health Connector website is the go-to place for applying for coverage and learning more about your options.

Native Hawaiian communities will receive special outreach to ensure they have access to the resources they need. This is a great example of how the Hawaii Health Exchange is committed to serving the entire community.

Navigators will be able to provide guidance on the decision-making process required to purchase health insurance or seek Medicaid qualification. They'll be able to answer your questions and help you find the right plan for your needs.

You can qualify for Medicaid expansion in Hawaii if you make under 139% of the Federal Poverty Level.

The Hawaii Health Insurance Exchange is where you can apply for Medicaid.

The Hawaii health insurance marketplace is only open during open enrollment, so be sure to mark your calendar.

You can sign up for our newsletter to stay updated on the latest information about the exchanges.

Location is a significant factor that affects the cost of your health insurance premium on the Hawaii health insurance exchange.

The cost of your premium will fluctuate from person to person and from family to family.

Income is another factor that impacts the cost of your health insurance premium.

Smoking status also plays a role in determining the cost of your premium.

Family size is an important factor to consider when shopping for insurance on the Hawaii health insurance exchange.

Age is a crucial factor that affects the cost of your health insurance premium.

Hawaii's open enrollment period for individual and family health coverage is from November 1 to January 15, set by the federal government since Hawaii uses the federal exchange.

If you enroll by December 15, your coverage will begin on January 1, but if you miss that deadline, any changes or new plans will start on February 1.

You can sign up for or make changes to an ACA Marketplace health plan through a special enrollment period (SEP), but you'll usually need a qualifying life event.

Some SEPs don't depend on a qualifying life event, such as if you're a Native American, you can enroll whenever necessary.

If you're eligible for premium tax credits and your income is not more than 150% of the poverty level, you can enroll anytime.

People eligible for Medicaid/CHIP (Med-QUEST in Hawaii) can enroll in that coverage anytime.

To enroll in an ACA-compliant plan in Hawaii, you'll need to provide some information, including last year's tax information for you and your family, employer and income information for every member of your household, and policy numbers for any current health insurance plans.

You can find affordable coverage through the Marketplace (HealthCare.gov) or Med-QUEST (Medicaid/CHIP), with 84% of Hawaii Marketplace enrollees receiving premium subsidies as of early 2024.

The average premium subsidy in Hawaii's Marketplace in early 2024 was $549/month, and even accounting for enrollees who paid full price, the average net premium paid by enrollees was $244/month.

If your income is no more than 250% of the federal poverty level, you may qualify for cost-sharing reductions (CSR) to reduce your deductibles and out-of-pocket expenses, as long as you select a silver plan through the Marketplace.

Here are some key dates to remember:

When choosing a plan on the Hawaii health insurance exchange, consider your budget carefully. Affordable health insurance is defined as 8% of your income, subject to adjustment each year.

Start by figuring out what you can afford to pay for health care this year. Take your income for last year and see if you can afford to pay 8% of it.

You can use the cost calculator from the Kaiser Family Foundation to get an estimate of what you and your family will pay.

Hawaii Medical Service Association is one of the Qualified Health Plans participating in the Hawaii Connector. Their individual plans are available on their website.

You can find Kaiser Foundation Health Plan of Hawaii in the list of participating plans as well. They offer individual and SHOP plans.

If you're looking for a plan, be sure to check the websites of these participating plans, including Hawaii Medical Service Association and Kaiser Foundation Health Plan of Hawaii.

Kaiser Foundation Health Plan of Hawaii's provider enrollment information can be found on their website.

You can also check out Hawaii Medical Service Association's provider enrollment page for more information.

The Hawaii Connector's list of participating plans is subject to change, so it's a good idea to check back for updates.

To determine your budget for health care, consider that affordable health insurance is defined as 8% of your income, subject to adjustment each year.

First, calculate 8% of your income for last year to get an idea of what you can afford to pay. If you can't afford 8%, find a number that feels manageable for you.

Using the Kaiser Family Foundation's cost calculator on the Hawaii health insurance exchange will give you an estimate of what you and your family will pay.

Health, age, and other factors can increase or decrease the cost of your insurance, so keep this in mind when using the calculator.

You can apply for Medicaid using the Hawaii Health Insurance Exchange if you make under 139% of the Federal Poverty Level.

In Hawaii, you have two private insurance companies offering individual/family health coverage through the state's health insurance Marketplace. These companies are Hawaii Medical Service Association (HMSA) and Kaiser Foundation Health Plan, Inc.

HMSA has 21,605 enrollees, while Kaiser has 10,996. The weighted average rate increase for 2025 is about 6.7%, based on full-price premiums.

Here's a summary of how average pre-subsidy premiums for ACA-compliant individual/family plans have changed each year in Hawaii:

In Hawaii, only two private insurance companies offer individual/family health coverage through the state's health insurance Marketplace.

Hawaii's Marketplace health insurance premiums are indeed increasing. In fact, the approved filings for 2025 show that the average pre-subsidy rate changes for two major issuers are significant.

HMSA's premium increase is a whopping 8%, while Kaiser's is a more modest 4%. But what does this mean for enrollees?

These average premium changes are based on full-price premiums, but most enrollees are eligible for subsidies. This means that the actual cost of premiums for many people will be lower than the full price.

To put these changes into perspective, here's a summary of how average pre-subsidy premiums for ACA-compliant individual/family plans have changed each year in Hawaii: