Follow the steps to complete the application successfully.

1. Press the ‘Get Form’ button to access the application. This will open the form in an editable format for you to begin filling it out.
2. In the 'Business Information' section, enter the legal business name. Ensure that it matches the name registered with the Hawaii Department of Labor and the DCCA.
3. Provide your business address, including street address, city, state, and zip code. If your billing address differs, fill out that information in the designated area.
4. Complete the contact details for a designated person in your business, including their name, phone number, fax number, and email address.
5. Select the type of business (e.g., Corporation, Partnership, Sole Proprietor, LLC, or Other) and provide the North American Industry Classification System number and federal tax identification number.
6. Specify the size of your business in terms of full-time equivalent employees (FTEs). Choose the appropriate category based on last year's employee count.
7. Indicate whether the business owners with 50% or more ownership will be enrolled in HMAA's plan and provide additional details about Workers' Compensation Insurance coverage.
8. Input the requested effective date of coverage using the specified month and year format.
9. For COBRA and Medicare information, ensure that all current enrollees are listed and any necessary reports are attached to maintain eligibility.
10. Complete the 'Certification & Acknowledgment' section by reviewing the statements carefully and signing before submitting the application.
11. Finally, review the entire application for completeness and accuracy, then save your changes, download a copy, print it for your records, or share it as needed.

Take the next step to secure your business's health coverage by completing the HI HMAA Business Application online today.