Hawaii Medical Assurance Association

What Hawaii Medical Assurance Association does

Hawaii Medical Assurance Association (HMAA) is a Hawaii-incorporated, non-profit health insurance company founded in 1989 by Arnold Baptiste, Sr. and headquartered at 220 S King Street, Suite 1200, Honolulu. It provides employer-sponsored health, dental, vision, prescription, life, AD&D, and wellness plans to more than 40,000 members across roughly thousands of Hawaii businesses. Its core product stack consists of three medical plan tiers — Option Plus One (OP1), Option Plus Two (OP2), and Comprehensive Plus — augmented by add-on modules for dental, vision, prescription drug coverage, life and AD&D, and a suite of wellness programs including HiDoc 24/7 telemedicine, the Baby & Me maternity incentive (up to $1,000), Active&Fit fitness, an Employee Assistance Program, alternative care (chiropractic, acupuncture, naturopathic), and a diabetes prevention program.

The company is administered by third-party administrator Hawaii-Western Management Group, Inc. (HWMG) and operates a member portal with mandatory 2FA, machine-readable files for Transparency in Coverage compliance, a price-comparison tool via Zakipoint Health's zConnect, and a QR-coded member ID card. Distribution combines direct enterprise sales with exclusive PPO Association Health Plan partnerships with five major Hawaii industry associations (Building Industry Association of Hawaii, Hawaii Food Industry Association, Hawaii Restaurant Association, Landscape Industry Council of Hawaii, and the Small Business Chamber of Commerce Hawaii), supplemented by PEO channel partners. Revenue is generated through recurring employer-paid premiums, with prescription benefits outsourced to OptumRx, telemedicine to MD Live by Evernorth, and mainland provider access via Cigna's network.

Name

Hawaii Medical Assurance Association

Legal name

Hawaii Medical Assurance Association

Website

https://hmaa.com

Company type

Private

Founded year

1989

Operating status

Operating

Headcount range

51–100 employees

Short description

Hawaii Medical Assurance Association (HMAA) is a Honolulu-based, non-profit health insurer founded in 1989 that provides employer-sponsored medical, dental, vision, prescription, and wellness plans to more than 40,000 members across Hawaii businesses via direct sales, exclusive association health plans, and PEO partners.

Ownership category

akta.pro rank

Product category

Health Insurance

NAICS

Direct Health and Medical Insurance Carriers (524114), Direct Life, Health, and Medical Insurance Carriers (52411)

SIC

Hospital & Medical Service Plans (6324), Insurance Agents, Brokers & Service (6411)

akta.pro primary industry

Association & PEO Group Health Plans (AHP/PEO-Sponsored) (FSAIAFAH)

akta.pro secondary industry

Vision Provider Networks (PPO/HMO) (FSAIAHAG)

Keywords

• Employer health insurance
• PPO health plans
• Association health plans
• Dental vision plans
• Wellness programs

Headquarters

HQ city

Honolulu

HQ country

United States

HQ region

North America

Offices1 record

Markets served

GTM type

B2B

Offering type

Services

Cost components

Personnel, Operations, Technology or R&D, Marketing or Sales, Supply Chain

Revenue model

1. Employer-Sponsored Health Insurance Premiums: HMAA generates revenue through employer-sponsored health insurance plans where businesses pay premiums to provide health coverage to their employees. Plans include medical, dental, vision, and prescription drug coverage.
2. Prescription Plan Riders: HMAA offers prescription plan riders to employers as add-on coverage, with pharmacy network and benefit management through OptumRx. Prescription plans are structured to encourage generic drug utilization.
3. Ancillary Benefits: Additional revenue streams include dental plans, vision plans, life insurance, AD&D, and the Active&Fit wellness program riders.

Pricing tiers

Go-to-market motion2 records

Distribution channels4 records

Marketing channels7 records

Core offering

HMAA provides employer-sponsored PPO health insurance plans for Hawaii businesses of all sizes, with three core medical tiers (Option Plus One, Option Plus Two, Comprehensive Plus) and supplemental add-ons including dental (800+ Hawaii dentists), vision, prescription drugs through OptumRx, life insurance and AD&D. Coverage includes low out-of-pocket maximums, alternative care benefits (chiropractic, acupuncture, naturopathic), 24/7 telemedicine (HiDoc), and free wellness programs like Baby & Me maternity incentives and Active&Fit.

Product overview

HMAA operates as a health insurance company offering a unified platform of employer-sponsored health plans and wellness programs for Hawaii businesses. The core product portfolio centers on three medical plan tiers (Option Plus One, Option Plus Two, and Comprehensive Plus) that can be supplemented with add-on modules including dental, vision, prescription drug, life insurance, and fitness programs. HMAA differentiates through integrated wellness offerings like the HiDoc telemedicine service, Baby & Me maternity program, Employee Assistance Program, and Alternative Care coverage (chiropractic, acupuncture, naturopathic). The company also provides Association Health Plans through exclusive partnerships with Hawaii industry associations, and member-facing digital tools including an online portal with 2FA, price comparison via zConnect, and machine-readable files for regulatory compliance. The prescription benefit is managed through OptumRx, while telemedicine is powered by MD Live through Evernorth.

Differentiator

Problem solved

Functional benefit

Products and services

• Option Plus One (OP1) Medical Plan HMAA's most popular medical plan for small and large Hawaii businesses, featuring low out-of-pocket maximums with included Chiropractic, Acupuncture, Naturopathic, Wellness and Preventive Care, and Employee Assistance Programs. Available with or without prescription drug coverage.
• Option Plus Two (OP2) Medical Plan Medical plan most comparable to Hawaii's largest Preferred Provider Plan (PPP), with added Chiropractic, Acupuncture, Naturopathic, Wellness and Preventive Care, and Employee Assistance Program benefits. Includes prescription coverage with drug and pediatric benefits for small businesses (1-50 employees).
• Comprehensive Plus Medical Plan Lower-cost HMAA medical plan alternative for large Hawaii businesses (51+ FTEs) featuring fixed copayments for office visits and minimal copayments for preventive benefits. Includes Chiropractic, Acupuncture, Naturopathic, Wellness and Preventive Care, and Employee Assistance Programs without drug and pediatric benefits.
• Dental Plans HMAA quality dental plans with an extensive network of more than 800 dentists throughout Hawaii. Available in Premier, Advanced, and Plus tiers with optional Orthodontia Rider.
• Vision Plans High-quality vision plans combining competitive pricing with a wide network of vision service providers, available to Hawaii employers as an add-on to medical coverage.
• Prescription Plans Prescription drug coverage structured to encourage generic drug utilization. Tiered options include $5/$20/$35 and $12/$24/$48 copay tiers with 20% coinsurance for medications exceeding $250. Pharmacy network and benefit management provided by OptumRx.
• Life Insurance and AD&D Supplemental life insurance and Accidental Death & Dismemberment coverage available when purchased alongside HMAA Medical Plans.
• Association Health Plans Exclusive PPO Association Health Plan offerings distributed through five partner industry associations: Building Industry Association of Hawaii, Hawaii Food Industry Association, Hawaii Restaurant Association, Landscape Industry Council of Hawaii, and Small Business Chamber of Commerce Hawaii. HMAA subsidizes up to $40/month ($480/year) of association membership dues for enrolled employers.
• HiDoc Telemedicine Free 24/7 telemedicine service providing virtual visits for primary care, mental health, and urgent care with no out-of-pocket cost to HMAA members. Powered by MD Live through Evernorth.
• Baby & Me Maternity Incentive Program Free maternity incentive program offering up to $1,000 in incentives for expectant mothers, including pregnancy support, fetal Doppler rental, free breast pump with accessories through Pharmacare Hawaii, prenatal class reimbursement up to $150, and postpartum support.
• Active&Fit Program Enterprise fitness program offered as an optional medical plan rider. Provides access to fitness center memberships, home fitness kits, and the Active&Fit Direct program, with a minimum age requirement of 13.
• Employee Assistance Program (EAP) Mental and behavioral health services including consultations for stress, anxiety, and other issues available to HMAA members through the free HiDoc telemedicine service.
• Pharmacy Discount Card Free individual pharmacy discount card offered through HMAA's Member Plus Discount Program via Optum Perks, providing savings up to 80% on select prescription medications at thousands of participating pharmacies nationwide. No membership or fees required.

Quantifiable outcome

• Up to $480 per year subsidy toward association membership dues
• +3 more outcomes

Named customers9 records

Segments4 records

Ideal customer profiles3 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Integration4 records

Feature4 records

Partnerships

18 partnerships are on record, tiered core and minor.

• Hawaii Restaurant Association (HRA)coreChannel Partner/ Reseller/ Distributor · 19 January 2021HMAA is the exclusive PPO Association Health Plan offering for HRA members. This partnership provides extensive health and wellness benefits and savings normally associated with large corporate health plans, with the richest plan in the market at the lowest out-of-pocket cost.
• Building Industry Association of Hawaii (BIA-Hawaii)coreChannel Partner/ Reseller/ DistributorHMAA is the exclusive PPO Association Health Plan offering for BIA-Hawaii members, providing preferred pricing and comprehensive health benefits to construction and building industry employers and their employees.
• Hawaii Food Industry Association (HFIA)coreChannel Partner/ Reseller/ DistributorHMAA is the exclusive PPO Association Health Plan offering for HFIA members, providing affordable health and wellness plans to food industry employers including grocers and food service businesses.
• Landscape Industry Council of Hawaii (LICH)coreChannel Partner/ Reseller/ DistributorHMAA is the exclusive PPO Association Health Plan offering for LICH members, providing quality health coverage to landscaping industry employers and their families.
• Small Business Chamber of Commerce HawaiicoreChannel Partner/ Reseller/ DistributorHMAA provides exclusive PPO Association Health Plan offerings for Small Business Chamber of Commerce Hawaii members, bringing affordable health benefits to small businesses throughout Hawaii.
• CignacoreTechnology or IntegrationHMAA utilizes Cigna's extensive mainland provider network to complement their Hawaii network, ensuring members have access to quality healthcare both locally and on the U.S. mainland.
• OptumRxcoreTechnology or IntegrationOptumRx serves as HMAA's pharmacy network and benefit manager, providing prescription drug coverage, formulary management, home delivery pharmacy services, and the Optum Perks discount card program.
• MD Live / Evernorth (HiDoc Telemedicine)coreTechnology or IntegrationHMAA provides free 24/7 telemedicine service called HiDoc through MD Live by Evernorth, offering virtual visits for primary care, mental health, and urgent care with no out-of-pocket cost for members.
• American Heart AssociationminorStrategic or Co-development PartnerPartnership focuses on social determinants of health to build awareness about healthier lifestyles, educating and supporting the community on heart and stroke-related preventive measures.
• March of DimesminorStrategic or Co-development PartnerMarch of Dimes provides information geared toward full-term pregnancies and healthy babies through HMAA's free maternity program Baby & Me.
• American Diabetes AssociationminorStrategic or Co-development PartnerADA's free Project Power program educates and engages children through fun afterschool experiences, available to HMAA members. Also provides diabetes education through Times Pharmacy's Teach Me Diabetes program.
• Pharmacare HawaiiminorStrategic or Co-development PartnerProvides free breast pumps with accessories to HMAA members through their medical plan and innovative maternity program, Baby & Me.
• Healthy Baby HawaiiminorStrategic or Co-development PartnerOffers special discounts on organic baby food products made from fresh, local ingredients to HMAA members through the Member Plus Discount Program.
• FIT4MOMminorStrategic or Co-development PartnerFIT4MOM Windward Kailua and FIT4MOM Ewa Beach offer special discounts on fitness programs to HMAA members through the Member Plus Discount Program, supporting prenatal and postnatal exercise.
• Healthy Mothers Healthy Babies Coalition of HawaiiminorStrategic or Co-development PartnerProvides new parent support programs on topics such as pregnancy anxiety, stress, and postpartum depression to HMAA members.
• Times PharmacyminorStrategic or Co-development PartnerTimes Pharmacy's Teach Me Diabetes education program includes 7 important health topics to help control blood sugar, covered for HMAA members.
• HI Now / Hawaii News NowminorGTM or Marketing PartnerMedia partnership for 'Ohana Moments series airing on Hawaii News Now: Sunrise (KGMB and KFVE), highlighting local businesses and wellness programs. Also produced 'Mommy Moments' series for parents.
• Hawaii-Western Management Group, Inc. (HWMG)coreOthersHWMG is the third-party administrator for HMAA and other clients. They manage the HMAA.com, HMAAonline.com, and OGA.HMAA.com websites and provide administrative services.

Scale indicators6 records

Recent moves6 records

Expansion highlights5 records

Others

• Optum (UnitedHealth Group): Optum is the health services and innovation arm of UnitedHealth Group, providing PBM, care delivery, and data/analytics services. It is comparable as a critical infrastructure partner in the health insurance value chain—analogous to HMAA's reliance on OptumRx for prescription benefit management—and represents both a partner ecosystem and a competitive vector.
• Cigna Healthcare: Cigna is both a strategic partner (provides mainland provider network access for HMAA members) and a competitor in the national employer-sponsored market. Comparable as a large commercial health insurer with PPO and HMO products targeting multi-state employers, though HMAA relies on Cigna for network reach rather than competing head-to-head in Hawaii.

Regional players

• Premera Blue Cross: Premera is the largest health insurer in the Pacific Northwest (Washington, Alaska), serving employer groups with PPO and integrated products. It is a comparable regional Blue plan operating in geographically isolated markets with concentrated employer bases and similar association distribution strategies.
• Blue Shield of California: Blue Shield of California is a tax-paying nonprofit Blue plan offering employer-sponsored PPO and HMO products in California. While not operating in Hawaii directly, it is structurally comparable as a regional nonprofit/Blue-affiliated carrier competing in a state-defined employer market with similar mission-driven positioning.

Broad incumbents

• Aetna (CVS Health): Aetna, owned by CVS Health, offers employer-sponsored group health insurance with national PPO networks and serves Hawaii businesses through national accounts. It competes for large multi-state employer contracts but has limited Hawaii-specific provider contracting depth compared to HMAA.
• UnitedHealthcare (UHC): UnitedHealthcare is the largest U.S. health insurer, offering employer-sponsored plans, Medicare Advantage, and individual coverage nationally including Hawaii. While it competes in Hawaii for large national employers, it does not focus on the SMB and association channels where HMAA is strongest.

Direct peers

• Kaiser Permanente Hawaii: Kaiser Permanente Hawaii operates an integrated HMO model with its own provider network, hospitals, and clinics across the islands. It competes directly with HMAA for Hawaii employer group business, particularly large employers, and represents the vertically integrated incumbent that HMAA's PPO model differentiates against.
• Hawaii Medical Service Association (HMSA): HMSA is Hawaii's largest health insurer and Blue Cross Blue Shield licensee, offering employer-sponsored PPO and HMO plans across the state. It is HMAA's primary direct competitor in the same Hawaii employer-group market with overlapping products (medical, dental, vision), similar association distribution models, and a mutual/non-profit structure.

Emerging players

• Humana: Humana is increasingly competing in employer-sponsored group health alongside its Medicare Advantage stronghold. While not a major Hawaii SMB player today, it represents an emerging threat if Humana expands group commercial offerings into Hawaii and leverages its senior-focused brand to court older employee populations.
• Centene (WellCare): Centene focuses on government-sponsored health programs (Medicaid, Medicare, ACA marketplace) and could expand into Hawaii employer-sponsored markets. Comparable as a managed care operator, though its Hawaii presence is currently limited and its model skews to subsidized populations rather than commercial group.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat5 records

Key risks6 records

Key highlights6 records

Customer concentration

• YouTubeyoutube.com/channel/UCahCbn5g3C78jXkImEG3Pig
• Facebookfacebook.com/hmaainsurance
• LinkedInlinkedin.com/company/hmaa-insurance
• Instagraminstagram.com/hmaa_insurance

Compliance2 records

Revenue estimate

Valuation estimate

Number of profiles

Profiles6 records

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Hawaii Medical Assurance Association