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Key to Health Plan Terms and Acronyms
Largest Private Health Plans:
The total market consists of the total number of lives covered by insurance whether from private or public sources. In 2007, HMSA and Kaiser Permanente continued in their market positions as the largest private health plans in Hawai'i, with 68 percent and 20 percent of the private market, respectively.
Employment-Based Coverage:
According to U.S. Census figures, of the people covered by private health plans in Hawai'i, 93 percent were covered through employment-based plans in 2004. This is up from 82 percent in 1990.1
Overlapping Coverage:
One in eleven Hawai'i residents was covered by more than one health plan in 2007.
Government Programs:
Overall, the number of covered lives in government sponsored plans has increased 29 percent since 1995, while the percent of individuals covered by private plans increased 2 percent. In total, government programs represented 36 percent of the covered lives in 2007.
Medicare, the federal government's coverage for the elderly, accounted for 35 percent of the government program covered lives in 2007; QUEST and Medicaid, state and federally-funded programs, represented 29 percent and 8 percent of government funded health plans respectively. TRICARE, the federal government's coverage for military-dependent and military retiree health care, accounted for 28 percent.
QUEST Plans: Current QUEST enrollment rates represent 10.6 percent of all covered lives. HMSA has the largest QUEST plan with 50 percent of all QUEST covered lives. AlohaCare is the second largest with 36 percent of all QUEST covered lives.
The decline in enrollment around the mid to late 1990s was primarily due to changes in eligibility requirements in 1996, including caps on the number of lives covered. HMSA's QUEST plan experienced a low enrollment of 26 percent of total QUEST covered lives in 2000, but has since regained its membership due to changes in the state's enrollment cap policies and the reduced number of participating plans.
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