BCBS Settlement Hawaii — HMSA (Hawaii Medical Service Association) Payout Guide

Hawaii's BCBS licensee is HMSA — Hawaii Medical Service Association, a nonprofit independent licensee of the Blue Cross Blue Shield Association. Founded in 1938, HMSA is the oldest and largest health insurer in Hawaii, covering an estimated 50% of the state's insured population across all six major islands. On the neighbor islands (Maui, Hawaii Island, Kauai, Molokai, and Lanai), HMSA is essentially the only private health insurer available.

Hawaii residents enrolled in an HMSA plan between February 7, 2008 and October 16, 2020 who filed a valid claim by November 5, 2021 are eligible for a Tier 1 individual payout from the settlement. Employer groups with premium-contribution arrangements qualify under Tier 2. Large self-funded employer accounts (excluding government accounts) may qualify for Tier 3. Payments began distributing in May 2026.

Hawaii's health insurance market is a duopoly unlike almost any other state: HMSA and Kaiser Permanente Hawaii together cover an estimated 98% of the insured population, according to an American Medical Association study. This leaves virtually no room for national carriers like Aetna, Cigna, or UnitedHealthcare in Hawaii's commercial market.

However, Kaiser Permanente is an integrated HMO — not a BCBS licensee — and its large presence (covering roughly 40% of Oahu's insured population) does represent genuine competition to HMSA. This is why Hawaii's BCBS multiplier falls into the upper-mid rather than the highest tier: HMSA faced more real competition from Kaiser than Premera faced in Alaska or Anthem faced in West Virginia. Still, Hawaii's isolated geography, mandatory employer coverage law (Hawaii Prepaid Health Care Act), and HMSA's island-wide dominance all point to above-average settlement payouts for HMSA claimants.

The BCBS licensee in Hawaii is HMSA (Hawaii Medical Service Association), an independent nonprofit mutual benefit society organized under Hawaii law. HMSA has been the state's leading health insurer since 1938 and is the only Blue Cross Blue Shield Association licensee in Hawaii. Unlike most BCBS entities on the mainland, HMSA operates entirely within Hawaii and has no parent company outside the state — it is governed by its own board as a Hawaii-chartered organization.

HMSA offers PPO, HMO, and federal employee plans across all major Hawaiian islands. On Oahu, HMSA competes primarily with Kaiser Permanente Hawaii; on the neighbor islands, HMSA is the predominant or sole commercial option. The HMSA portal for EUTF (state employee) coverage and the general member portal are both managed at hmsa.com. HMSA's Blue Cross Blue Shield affiliation subjects it to the same national association rules that formed the basis of the antitrust litigation.

Hawaii HMSA claimants with valid claims are part of the May 2026 distribution wave. Checks and electronic payments began going out May 11, 2026. Claimants who moved or changed bank accounts since filing in 2021 should update their contact information at bcbssettlement.com as soon as possible to avoid returned or undelivered payments.

Local Hawaiian media including the Honolulu Star-Advertiser and Hawaii News Now have covered the settlement distribution. Hawaii's mandatory employer health insurance law (the Prepaid Health Care Act) means a higher proportion of working-age Hawaiians have had continuous employer-sponsored health coverage compared to other states — many through HMSA — which may increase the pool of potentially eligible claimants. Tier 3 self-funded employer account payments follow a separate schedule from the $120 million self-funded fund.

• EUTF (Employer-Union Health Benefits Trust Fund) — Hawaii state and county government employees and retirees covered through the EUTF are enrolled through a government account and are excluded from the settlement. EUTF covers State of Hawaii, City and County of Honolulu, and county employees. Even though EUTF offers HMSA plans, those government-account enrollees are excluded.
• Kaiser Permanente Hawaii enrollees — Kaiser is not a Blue Cross Blue Shield licensee. Oahu residents or neighbor island residents whose only coverage was Kaiser Permanente during the class period are not part of the BCBS settlement class at all.
• HMSA Medicare Advantage / Medicare Supplement plans — Medicare plans are not included in the settlement class, which covers commercial (non-Medicare) health insurance only.
• Medicaid / Med-QUEST — Hawaii's Medicaid program (Med-QUEST) is a government program and not eligible for the settlement.
• TRICARE / CHAMPVA — Military and veterans' federal health programs are government accounts and are excluded.
• Federal Employee Program (FEP) — Federal employees in Hawaii covered under the BCBS Federal Employee Program are excluded as federal government account members.