COBRA – FAQs

How do I become eligible for COBRA continuation coverage?

To be eligible for COBRA coverage, you must have been enrolled in your employer’s health plan when you worked and the health plan must continue to be in effect for employees/retirees. COBRA continuation coverage is available upon the occurrence of a qualifying event that would, except for the COBRA continuation coverage, cause an individual to lose his or her health care coverage.

What are some examples of qualifying events?

Qualifying events eligible for COBRA continuation of coverage include:

  • Death of a covered employee (if dependents not eligible for survivor benefits)
  • Termination of employment for reasons other than gross misconduct
  • Reduction in work hours
  • Covered employee’s becoming entitled to Medicare
  • Divorce or legal separation of a covered employee and spouse
  • A child’s loss of dependent status (and therefore coverage) under the plan

View all COBRA qualifying events.

How long do I have to elect COBRA coverage?

If you are entitled to elect COBRA coverage, you must be given an election period of at least 60 days to choose whether or not to elect continuation coverage.

If I waive COBRA coverage during the election period, can I still get coverage at a later date?

If you waive COBRA coverage during the election period, you will only be permitted to revoke your waiver of coverage and to elect continuation coverage as long as you do so within the 60 day election period. Then, the plan need only provide continuation coverage beginning on the date you revoke the waiver.

Under COBRA, what benefits must be covered?

If you elect continuation coverage, the coverage you are given must be identical to the coverage currently available under the plan to similarly situated employees/retirees and their families (generally, this is the same coverage that you had immediately before the qualifying event). You will also be entitled, while receiving continuation coverage, to the same benefits, choices, and services that a similarly situated participant or beneficiary is currently receiving under the plan, such as the right during open enrollment season to choose among available coverage options.

How long does COBRA coverage last?

COBRA requires that continuation coverage extend from the date of the qualifying event for a limited period of 18 or 36 months. The length of time depends on the type of qualifying event that gave rise to the COBRA rights.

When the qualifying event is the covered employees/retirees termination of employment or reduction in hours of employment, qualified beneficiaries are entitled to 18 months of continuation coverage.

When the qualifying event is the end of employment or reduction of the employee’s hours, and the employee became entitled to Medicare less than 18 months before the qualifying event, COBRA coverage for the employee’s spouse and dependents can last until 36 months after the date the employee becomes entitled to Medicare.

For other qualifying events, qualified beneficiaries must be provided 36 months of continuation coverage.

Can COBRA continuation coverage be terminated early for any reason?

A group health plan may terminate coverage earlier than the end of the maximum period for any of the following reasons:

  • Premiums are not paid in full on a timely basis;
  • The employer ceases to maintain any group health plan;
  • A qualified beneficiary begins coverage under another group health plan after electing continuation coverage;
  • A qualified beneficiary becomes entitled to Medicare benefits after electing continuation coverage; or
  • A qualified beneficiary engages in conduct that would justify the plan in terminating coverage of a similarly situated participant or beneficiary not receiving continuation coverage (such as fraud).

If continuation coverage is terminated early, the plan must provide the qualified beneficiary with an early termination notice. The notice must be given as soon as practicable after the decision is made, and it must describe the date coverage will terminate, the reason for termination, and any rights the qualified beneficiary may have under the plan or applicable law to elect alternative group or individual coverage.

If you decide to terminate your COBRA coverage early, you generally won’t be able to get a Marketplace plan outside of the open enrollment period. For more information on alternatives to COBRA coverage, see question: ‘If I waive COBRA coverage during the election period, can I still get coverage at a later date?‘.

 

Can I extend my COBRA continuation coverage?

If you are entitled to an 18 month maximum period of continuation coverage, you may become eligible for an extension of the maximum time period in two circumstances. The first is when a qualified beneficiary is disabled; the second is when a second qualifying event occurs.

Disability

If any one of the qualified beneficiaries in your family is disabled and meets certain requirements, all of the qualified beneficiaries receiving continuation coverage due to a single qualifying event are entitled to an 11-month extension of the maximum period of continuation coverage (for a total maximum period of 29 months of continuation coverage). The plan can charge qualified beneficiaries an increased premium, up to 150 percent of the cost of coverage, during the 11-month disability extension.

The requirements are:

  1. that the Social Security Administration (SSA) determines that the disabled qualified beneficiary is disabled before the 60th day of continuation coverage; and
  2. that the disability continues during the rest of the 18-month period of continuation coverage. The disabled qualified beneficiary or another person on his or her behalf also must notify the plan of the SSA determination. The plan can set a time limit for providing this notice of disability, but the time limit cannot be shorter than 60 days, starting from the latest of: (1) the date on which SSA issues the disability determination; (2) the date on which the qualifying event occurs; (3) the date on which the qualified beneficiary loses (or would lose) coverage under the plan as a result of the qualifying event; or (4) the date on which the qualified beneficiary is informed, through the furnishing of the SPD or the COBRA general notice, of the responsibility to notify the plan and the procedures for doing so.

The right to the disability extension may be terminated if the SSA determines that the disabled qualified beneficiary is no longer disabled. The plan can require qualified beneficiaries receiving the disability extension to notify it if the SSA makes such a determination, although the plan must give the qualified beneficiaries at least 30 days after the SSA determination to do so.

The rules for how to give a disability notice and a notice of no longer being disabled should be described in the plan’s SPD (and in the election notice if you are offered an 18-month maximum period of continuation coverage).

Second Qualifying Event

If you are receiving an 18-month maximum period of continuation coverage, you may become entitled to an 18-month extension (giving a total maximum period of 36 months of continuation coverage) if you experience a second qualifying event that is the death of a covered employee, the divorce or legal separation of a covered employee and spouse, a covered employee’s becoming entitled to Medicare (in certain circumstances), or a loss of dependent child status under the plan. The second event can be a second qualifying event only if it would have caused you to lose coverage under the plan in the absence of the first qualifying event. If a second qualifying event occurs, you will need to notify the plan.

The rules for how to give notice of a second qualifying event should be described in the plan’s SPD (and in the election notice if you are offered an 18-month maximum period of continuation coverage). The plan can set a time limit for providing this notice, but the time limit cannot be shorter than 60 days from the latest of: (1) the date on which the qualifying event occurs; (2) the date on which you lose (or would lose) coverage under the plan as a result of the qualifying event; or (3) the date on which you are informed, through the furnishing of either the SPD or the COBRA general notice, of the responsibility to notify the plan and the procedures for doing so.

Is a divorced spouse entitled to COBRA coverage from their former spouses’ group health plan?

Under COBRA, participants, covered spouses and dependent children may continue their plan coverage for a limited time when they would otherwise lose coverage due to a particular event, such as divorce (or legal separation). A covered employee’s spouse who would lose coverage due to a divorce may elect continuation coverage under the plan for a maximum of 36 months. A qualified beneficiary must notify the plan administrator of a qualifying event within 60 days after divorce or legal separation. After being notified of a divorce, the plan administrator must give notice, generally within 14 days, to the qualified beneficiary of the right to elect COBRA continuation coverage.

Who pays for COBRA coverage?

Your group health plan can require you to pay for COBRA continuation coverage. The amount charged to qualified beneficiaries cannot exceed 102% of the cost to the plan for similarly situated individuals covered under the plan who have not incurred a qualifying event. In determining COBRA premiums, the plan can include the costs paid by employees and the employer, plus an additional 2% for administrative costs.

For qualified beneficiaries receiving the 11-month disability extension, the COBRA premium for those additional months may be increased to 150% of the plan’s total cost of coverage for similarly situated individuals.

COBRA charges to qualified beneficiaries may be increased if the cost to the plan increases but generally must be fixed in advance of each 12-month premium cycle. The plan must allow you to pay the required premiums on a monthly basis if you ask to do so, and the plan may allow you to make payments at other intervals (for example, weekly or quarterly). The election notice should contain all of the information you need to understand the COBRA premiums you will have to pay, when they are due, and the consequences of late payment or nonpayment.

When you elect continuation coverage, you cannot be required to send any payment with your election form. You can be required, however, to make an initial premium payment within 45 days after the date of your COBRA election (that is the date you mail in your election form, if you use first-class mail). Failure to make any payment within that period of time could cause you to lose all COBRA rights. The plan can set premium due dates for successive periods of coverage (after your initial payment), but it must give you the option to make monthly payments, and it must give you a 30-day grace period for payment of any premium.

You should be aware that if you do not pay a premium by the first day of a period of coverage, but pay the premium within the grace period for that period of coverage, the plan has the option to cancel your coverage until payment is received and then reinstate the coverage retroactively back to the beginning of the period of coverage. Failure to make payment in full before the end of a grace period could cause you to lose all COBRA rights.

If the amount of a payment made to the plan is incorrect but is not significantly less than the amount due, the plan is required to notify you of the deficiency and grant a reasonable period (for this purpose, 30 days is considered reasonable) to pay the difference. The plan is not obligated to send monthly premium notices.

Some employers may subsidize or pay the entire cost of health coverage, including COBRA coverage, for terminating employees and their families as part of a severance agreement. If you are receiving this type of severance benefit, talk to your plan administrator about how this impacts your COBRA coverage or your special enrollment rights.

If I did not make the premium payment on time and my coverage was canceled what can I do?

You may want to contact your plan and ask if they will reinstate your coverage; however, if your coverage was terminated for not making the payment within the grace period, the plan is not required to reinstate your coverage.

EUTF Active

My child is/will be attending college. What do I need to submit to the EUTF to confirm they are a full-time student?

Acceptable forms of student certification include:

  • Signed letter from the school’s registrar written on the school’s letterhead indicating full-time student status
  • Student enrollment verification form from www.studentclearninghouse.org

Copies of a class schedule, payment or tuition, or similar documents will not be accepted.

The EUTF will mail a courtesy reminder letter two months prior to your dependent’s birthday.  Student certification must be submitted to the EUTF within 15 days of the dependent’s birthday in order to avoid termination of their dental and/or vision plans.  If EUTF does not receive student certification prior to the end date listed on the courtesy reminder, a COBRA Election Notice will generate and coverage will stop at the end of that pay period.  In order to maintain enrollment, student certification must be renewed annually.

EUTF Administrative Rules 1.02 and 5.05(b) specify that dependent-beneficiaries ages 19 through 23 who are full-time students may enroll in dental and/or vision plans.  Children may be enrolled in medical and prescription drug plans until age 26 regardless of whether they are a full-time student or not.

I’m a new State or County employee and want to learn more about my health plan options. Is there educational material available?

Yes.  An on-demand video is available that covers enrollment procedures, eligibility criteria and a summary of EUTF health plan options and other benefits.  For more information, you can also download the EUTF New Hire Enrollment Guide.

Why did I receive a COBRA General Notice in the mail?

You will receive a COBRA General Notice if you make changes to your plan enrollment.  This notice contains information about your right to COBRA continuation coverage, which is a temporary extension of coverage under EUTF plans when coverage under the plan would normally cease.  This notice generally explains COBRA continuation coverage, when it may become available to you and your family, and what you need to do to protect the right to receive it.  For more information on COBRA, click here.

Why did I receive a COBRA Election Notice?

The COBRA Election Notice offers employees and/or their dependents temporary continuation of their health plan coverage when their coverage would otherwise end because of certain qualifying events (i.e., end of employment, child ceasing to be an eligible dependent child, etc.).  The maximum period of COBRA coverage is generally either 18 or 36 months, depending on which qualifying event occurred.  To watch a short overview on COBRA, click here.

Who is eligible for active employee health benefits?

Active employees include those who are employed by the State or County who will be working for more than three months in a position that requires more than 50% full-time equivalent.  As an active employee you are eligible to enroll:

  • Yourself
  • Your spouse or domestic partner
  • Your children under age 26 for medical and prescription drug coverage.  This includes children by birth, marriage, adoption, placement for adoption or foster child.  For dental and vision coverage, dependent children under age 19, and from age 19 through age 23 if they are unmarried and a full-time student.  For children covered under legal guardianship, their coverage will terminate at 18.
  • Your child, regardless of age, who are incapable of self-support because of a mental or physical impairment that existed prior to the child reaching age 19.

Part-time and temporary employees not eligible for the EUTF health plans should contact their departmental human resources or personnel office for more information.

I’m having a baby. What do I need to do to enroll my baby in my health plans?

Complete an EC-1 enrollment form (or EC-1H for HSTA VB members) and submit it to your departmental human resources office or enrollment designee within 180 days of the baby’s birthday.  For DOE employees, you must submit your form to:

DOE-EBU
PO Box 2360
Honolulu, HI 96804

A copy of the birth certificate is required only if the child has a different last name than you.  You can add your baby to your current plans – you cannot change plans.  Please submit your child’s Social Security Number to the EUTF once it’s issued by the Social Security Administration.  For more information, please see the Newborn Checklist.

If I have a baby, can I also enroll my spouse/partner to the plan?

Yes.  To enroll your spouse/partner, add their information to the EC-1 enrollment form (or EC-1H for HSTA VB members) and submit it to your departmental human resources office or enrollment designee within 180 days of the baby’s birthday.  For DOE employees, you must submit your form to:

DOE-EBU
PO Box 2360
Honolulu, HI 96804

If you are enrolling your spouse/partner for the first time in EUTF plans, please submit a copy of your marriage certificate or domestic partnership documents. You can add your spouse to your current plans – you cannot change plans.

I’m getting married and want to add my spouse. What do I need to do?

Complete an EC-1 enrollment form (or EC-1H for HSTA VB members) and submit it to your departmental human resources office or enrollment designee within 30 days of your marriage date.  For DOE employees, you must submit your form to:

DOE-EBU
PO Box 2360
Honolulu, HI 96804

Attach a copy of your marriage certificate or if it’s not available within 30 days, send it to the EUTF within 60 days of your marriage date.  You can add your spouse to your current plans – you cannot change plans.

I’m getting divorced and I’m covered under my spouse’s non-EUTF plan. What should I do?

Complete an EC-1 enrollment form (or EC-1H for HSTA VB members) and submit it to your departmental human resources office or enrollment designee within 30 days of your loss of coverage under your spouse’s plan.  For DOE employees, you must submit your form to:

DOE-EBU
PO Box 2360
Honolulu, HI 96804

Attach a loss of coverage letter from your former spouse’s employer or the health benefits carrier detailing the type of coverage lost, the date of loss, and the names of who lost coverage.  Your effective date of coverage under EUTF plans is the day following your loss of coverage under your former spouse’s plan.

I’m getting divorced and my spouse is covered under my EUTF plans. What should I do?

Employees must terminate their spouse’s/partner’s coverage within 30 days of the date of divorce.  Complete an EC-1 enrollment form (or EC-1H for HSTA VB members) and submit it to your departmental human resources office or enrollment designee within 30 days of your divorce date to terminate your spouse’s coverage.  For DOE employees, you must submit your form to:

DOE-EBU
PO Box 2360
Honolulu, HI 96804

Attach pages 1 and 2 of the divorce decree along with the signature page.  If the EC-1/EC-1H is filed more than 60 days after the date of divorce, the employee will be responsible for paying the employer contribution of premiums retroactive to the divorce date.  Your former spouse’s coverage ends the first date of the first pay period following the divorce.

I was covered under my spouse’s health insurance and we recently lost our coverage. Can I enroll into my EUTF coverage right away?

Yes.  Complete an EC-1 enrollment form (or EC-1H for HSTA VB members) and submit it to your departmental human resources office or enrollment designee within 30 days from the date you lost coverage under your spouse’s plan.  For DOE employees, you must submit your form to:

DOE-EBU
PO Box 2360
Honolulu, HI 96804

Attach a loss of coverage letter from your spouse’s employer or the health benefits carrier detailing the type of coverage lost, the date of loss, and the names of who lost coverage.  Your effective date of coverage under EUTF plans is the day following your loss of coverage under your spouse’s plan.

What are my options for insurance coverage when I’m on leave without pay?

If your leave without pay (LWOP) is expected to last longer than 30 days, you have two options:

  1. Cancel your health benefit plan enrollment during your leave of absence.
    • You must complete an EC-1 enrollment form (or EC-1H for HSTA VB members) within 30 days from your authorized leave date to cancel coverage, and may enroll in the same health plans upon return from leave by submitting an EC-1/EC-1H form within 30 days from your return date. The effective date of the cancellation will be the first day of the first pay period following your LWOP start date.
  2. Continue all your plans during your leave of absence by paying the premiums due by the end of the month.
    • Employees are responsible for submitting premium payments to the EUTF by check, electronic check, credit card or ACH payment. For more information on premium payment options, please click here.

If you do not submit an EC-1/EC-1H enrolment form within 30 days to cancel your coverage and do not make payment to the EUTF, your plans will be cancelled due to non-payment.  You may enroll during the next open enrollment or if you experience a qualifying life event.

If you are on leave without pay for a period less than 30 days, you could still have a premium shortage.  Employees on leave should check their paystub to see if they need to submit a premium payment to the EUTF.

For employees on Family Medical Leave of Absence without pay:  If you continue plans but do not submit payment to the EUTF by the due date indicated on the Shortage notice, your plans will be cancelled effective the due date on the notice.

For Uniformed Services Employment and Reemployment Rights Act (USERRA): If you continue plans but do not submit payment to the EUTF by the due date indicated on the shortage notice, your plans will be cancelled retroactive to your leave of absence date.

My dependent is no longer eligible (i.e., divorce, legal separation or dissolution of domestic partnership, etc.). Do I need to notify the EUTF?

Divorced or legally separated spouse/civil union partners, or domestic partners whose partnership has been dissolved are no longer eligible for EUTF plans, regardless of whether your divorce decree indicates that coverage must be afforded to your spouse.  You must notify the EUTF within 30 days from the divorce or legally separated filing dates or date of the termination of domestic partnership and terminate your dependent’s coverage.

Complete an EC-1 enrollment form (or EC-1H for HSTA VB members) and submit it to your departmental human resources office or enrollment designee within 30 days to remove your dependent from your EUTF plans.  For DOE employees, you must submit your form to:

DOE-EBU
PO Box 2360
Honolulu, HI 96804

Your dependent will be terminated the first day of the first pay period following their loss of eligibility.  If the EC-1/EC-1H is filed more than 60 days after the date of divorce/partnership, the employee shall be responsible for paying the employer contribution of premiums retroactive to the divorce date.

My child is no longer eligible (i.e., graduated from college, is no longer a full-time student, etc.), but is under age 24. Do I need to notify the EUTF?

You must notify the EUTF and terminate your child’s dental and vision coverage within 30 days from when they become ineligible.  This does not apply to medical and prescription drug coverage, which they may remain enrolled in to age 26.

Complete an EC-1 enrollment form (or EC-1H for HSTA VB members) and submit it to your departmental human resources office or enrollment designee within 30 days to remove your dependent from your EUTF plans.  For DOE employees, you must submit your form to:

DOE-EBU
PO Box 2360
Honolulu, HI 96804

Your child will be terminated the first day of the first pay period following their loss of eligibility.

How do I change my address?

Complete an Employee Address Change Form and submit it to your departmental human resources office or enrollment designee as soon as possible. For DOE employees, you must submit your form to:

DOE-EBU
PO Box 2360
Honolulu, HI 96804

The EUTF will process your change of address and notify each of the health plan carriers.   Be advised that all address changes must go through the EUTF and not to the health plan carriers directly.

Will I get new health plan ID cards every year?

No.  ID cards are only issued for new enrollments or when you make changes to your plan enrollment.  ID cards are not issued for HMA, American Specialties Health Group Inc., and VSP, as ID cards are not required to receive services.

Where can I get more information on EUTF plan options for active employees, enrollment procedures and eligibility criteria?

The EUTF Reference Guide for Active Employees is published annually and contains information on enrollment and eligibility, premiums and contributions, health plan options and how to make changes to your plans.  To download the guide, click here and select the Reference Guide you wish to view.

Does EUTF offer the Island Flex Plan?

No.  For State employees, the Island Flex Plan is administered by the State Department of Human Resources Development (DHRD).  For more information, please visit the website of the plan’s third-party administrator, Comprehensive Financial Planning, Inc. at http://www.CompFinPlan.com.  For County employees, contact your personnel office for more information.

Where can I get more information on the Premium Conversion Plan?

For State employees, the Premium Conversion Plan (PCP) is a voluntary benefit plan, administered by the State Department of Human Resources Development (DHRD) that allows employees to pay their health benefit plan premiums on a pretax basis and is being offered pursuant to Section 125 of the Internal Revenue Code. For more information click here.  For County employees, contact your personnel office for more information.

I’m an active employee considering retirement. Where can I learn more about what is needed to enroll in EUTF retiree plans?

Sign-up to attend a pre-retirement health benefits workshop, watch an on-demand pre-retirement informational video, or view the Pre-retirement Checklist and Medicare Checklist.

If I’m killed in the performance of duty, what will happen to my family’s health coverage?

The surviving spouse/partner of an employee killed in the performance of duty is eligible to enroll in retiree plans, provided the spouse or partner does not remarry or enter into another domestic or civil union partnership.  Additionally, the unmarried child of an employee killed in the performance of duty is eligible to be enrolled in retiree plans, provided the child is under the limiting age, as defined in the EUTF Administrative Rule 1.02 or is an adult disabled child in accordance with the EUTF Administrative Rule 3.01(b)(3) and does not have a surviving parent who is eligible to be an employee-beneficiary.

If I die before I retire, is my spouse/partner eligible for EUTF health coverage?

The surviving spouse/partner and/or unmarried child of a deceased employee is eligible to enroll in EUTF retiree plans provided the deceased employee was eligible on his/her date of death to retire with the Employees’ Retirement System (ERS).  In order to continue enrollment in EUTF retiree plans, the surviving spouse/partner may not remarry or enter into another domestic or civil union partnership.  The surviving child of a deceased employee is eligible to enroll in retiree plans provided the child is under the age of 19 and does not have a surviving parent who is eligible to be an employee-beneficiary.

EUTF Retiree

I’ve recently retired and enrolled in EUTF retiree health plans. Why am I receiving COBRA Continuation of Benefits Enrollment material?

For retirees who were enrolled in EUTF Active plans at the time of their retirement, once the EUTF receives an EC-1 form from your employer to terminate your active coverage, you will receive a COBRA Continuation of Coverage Election Notice from the EUTF.  COBRA allows you to continue some or all of your Active EUTF health plans.  Keep in mind that if you elect COBRA, you will be responsible for 110% of the premium cost.  The EUTF is required by federal law to offer COBRA to members who terminate EUTF health plans.

Click for more information about COBRA for retirees.

I am enrolled in EUTF retiree health plans and will be eligible for Medicare in a few months. What do I need to do?

The Hawaii Revised Statutes 87A-23(4) requires that State and County retirees and their eligible dependents who are enrolled in EUTF retiree medical and/or prescription drug benefit plans, must be enrolled in Medicare Part B when they become eligible.  Please provide proof of Medicare Part B enrollment to the EUTF within 60 days of becoming eligible.  If you and/or your covered dependent(s) are Medicare eligible and covered under EUTF retiree medical and/or prescription drug plans you must submit a copy of your and/or your dependent’s Medicare card (indicating enrollment into Medicare Part B), Medicare Part B Reimbursement Direct Deposit Agreement Form, and Social Security Administration letter for you and/or your dependent indicating the Medicare Part B Premium amount.  If you do not provide proof of Medicare Part B enrollment to the EUTF within 60 days of becoming eligible, your and/or your dependent’s EUTF retiree medical and/or prescription drug plans will be cancelled.

Click for a copy of the EUTF Medicare Checklist.

I pay a monthly premium for my EUTF retiree health plans. What are my premium payment options other than mailing in my payment to the EUTF?

If you are currently paying your healthcare premiums via check to the EUTF, you now have four other payment options:

  1. Premiums automatically deducted each month from your Employees’ Retirement System (ERS) pension.
  2. Monthly reoccurring electronic transfers from your bank account initiated and adjusted by the EUTF.
  3. Credit card for a fee of $2.50 plus 2.25% of the premium amount.
  4. Electronic transfers from your bank account that you initiate for a fee of $3.50 per transaction.

Click to initiate payment transactions or for more information.

How do I change my address?

Retirees may complete and submit a Retiree Address Change Form.  Once the Retiree Address Change Form is received, the EUTF will notify the health carriers of your new address. Be advised that all address changes must go through the EUTF, as health plan carriers are not able to make changes.

Where can I get more information on EUTF plan options for retirees, enrollment procedures and eligibility criteria?

The Health Benefits Retiree Reference Guide is published annually and mailed to retirees in the Fall.  The Reference Guide contains information on EUTF policies and procedures, enrollment and eligibility, employer contribution, health plan options, the EC-2 enrollment form, and Common Qualifying Events chart.

Do I need to turn in my Income-Related Monthly Adjustment Amount (IRMAA) to get reimbursement for Medicare Part B?

Yes.  The EUTF will need a copy of your Medicare card, Direct Deposit Agreement Form, and Social Security Administration letter indicating your Medicare Part B premium or IRMAA.  EUTF will automatically reset your Medicare Part B premium reimbursement to the Medicare standard amount every January 1st. If you are paying above the Medicare standard amount you must submit a letter from the Social Security Administration indicating the amount you are paying every year to receive full reimbursement.

Will I be reimbursed for Medicare Part D premiums if I’m being charged by Social Security?

No, EUTF is not authorized under Hawaii Revised Statutes 87A to reimburse Medicare Part D premiums.

Can I change plans if I move out of the coverage area?

You may change plans if you are enrolled in the EUTF retiree Kaiser plan and move out of the service area. You have 30 days to notify EUTF and may switch to the HMSA 90/10 plan.  Please complete an EC-2 enrollment form (or EC-2H for HSTA VB members) and submit it to the EUTF within 30 days of moving out of the coverage area.

Does my spouse or I need to be covered under an EUTF active employee plan at the time of retirement to be eligible to enroll in the EUTF retiree plans?

No, you do not need to be enrolled in Active plans for any amount of time or be enrolled in the EUTF Active plan at all to qualify for EUTF retiree benefits.

If I retire from the State or County and later return to work for the State or County, do I need to notify the EUTF?

Yes, if you return to work full-time for the State or County you must notify the EUTF to stop your EUTF retiree plans and you may enroll in EUTF Active plans.  If you return to work part-time or outside of the State or County, this does not apply to you.

I’m getting divorced and my spouse is covered under my EUTF plans. What should I do?

Retirees must terminate their spouse’s/partner’s coverage within 30 days of the date of divorce.  Complete an EC-2 enrollment form (or EC-2H for HSTA VB members) and submit it to the EUTF within 30 days of your divorce date to terminate your spouse’s coverage.  Attach pages 1 and 2 of the divorce decree, along with the signature page.

If the EC-2/EC-2H is filed more than 60 days after the date of divorce, the retiree will be responsible for paying the employer contribution of premiums retroactive to the divorce date.

I’m getting married and want to add my spouse. What do I need to do?

Complete an EC-2 enrollment form (or EC-2H for HSTA VB members) and submit it to the EUTF within 30 days of your marriage date.  Attach a copy of your marriage certificate or if it’s not available within 30 days, send it to the EUTF within 60 days of your marriage date.  You can add your spouse to your current plans – you cannot change plans.

My dependent is no longer eligible (i.e., divorce, legal separation or dissolution of domestic partnership, etc.). Do I need to notify the EUTF?

Divorced or legally separated spouse/civil union partners, or domestic partners whose partnership has been dissolved are no longer eligible for EUTF plans, regardless of whether your divorce decree indicates that coverage must be afforded to your spouse.  You must notify the EUTF within 30 days from the divorce or legally separated filing dates or date of the termination of domestic partnership and terminate your dependent’s coverage.

Complete an EC-2 enrollment form (or EC-2H for HSTA VB members) and submit it to the EUTF within 30 days to remove your dependent from your EUTF plans.  If the EC-2/EC-2H is filed more than 60 days after the date of divorce/partnership, the retiree shall be responsible for paying the employer contribution of premiums retroactive to the divorce date.

My child is no longer eligible (i.e., graduated from college, no longer a full-time student, etc.), but is under the age of 24. Do I need to notify the EUTF?

You must notify the EUTF and terminate your child’s medical, prescription drug, dental and vision coverage within 30 days from when they become ineligible.

Complete an EC-2 enrollment form (or EC-2H for HSTA VB members) and submit it to the EUTF within 30 days to remove your dependent from your EUTF plans.

My spouse passed away. What do I need to do?

Please see the Death checklist for more information.

What and when is open enrollment?

Open Enrollment is your opportunity to make changes to your plan enrollment.  During Open Enrollment you can:

  • Add, change or cancel plans
  • Add or remove dependents
  • Change coverage tiers such as changing from single to family, or family to two party

You will be mailed a Retiree Reference Guide which will notify you of the upcoming Open Enrollment period.  Please make sure that your address is current so that you don’t miss out on this and other EUTF communications.  Open Enrollment usually takes place in the month of October and plan and premium changes become effective Jan. 1st.

How and when will I be reimbursed for my Medicare Part B premiums?

The following must be submitted to the EUTF in order to receive reimbursement of Medicare Part B premiums:

  1. Copy of your Medicare card indicating enrollment in Medicare Part B
  2. Medicare Part B Premium Reimbursement Request and Direct Deposit Agreement Form
  3. Social Security Administration letter indicating the amount of your monthly Medicare Part B premium

Under current law, the amount of your Medicare Part B reimbursement is the amount you are charged by Medicare (minus any penalties). Generally, your reimbursement will be deposited quarterly during the first week of April, July, October and January for the prior quarter.

Why am I required to enroll in Medicare Part B when I am eligible?

The requirement for all State and County retirees and dependents to enroll in Medicare Part B was set forth in Act 88, 2001 Session Laws of Hawaii. This Act created Chapter 87A, Hawaii Revised Statutes (HRS), which includes the following statute:

 Section 87A-23(4): “All employee-beneficiaries or dependent-beneficiaries who are eligible to enroll in the Medicare Part B medical insurance plan shall enroll in that plan as a condition of receiving contributions and participating in benefits plans under this chapter. This paragraph shall apply to retired employees, their spouses or, and the surviving spouses of deceased retirees and employees killed in the performance of duty;”

Who is eligible for retiree health benefits?

As a State or County retiree, you are eligible to enroll:

  • Yourself
  • Your spouse, or domestic or civil union partner
  • Your children under age 19.  Children under age 24 if unmarried and a full-time student.  Dependent children include those by birth, marriage, foster, adoption or placement for adoption
  • Your child, regardless of age, who is incapable of self-support because of a mental or physical impairment that existed prior to the child reaching age 19.

In addition, the following persons are eligible for Retiree health benefits:

  • The surviving spouse of an employee killed in the performance of the employee’s duty, provided he or she does not enter into another marriage or domestic partnership
  • The surviving spouse of a deceased retiree or a deceased employee who at the time of death was eligible for retirement, provided he or she does not enter into another marriage or domestic partnership
  • The unmarried child of a deceased retired employee, provided the child is under age 19 with no surviving parent who is eligible to be covered as a surviving spouse

HSTA VB Active

My child is/will be attending college. What do I need to submit to the EUTF to confirm they are a full-time student?

Acceptable forms of student certification include:

  • Signed letter from the school’s registrar written on the school’s letterhead indicating full-time student status
  • Student enrollment verification form from www.studentclearninghouse.org

Copies of a class schedule, payment or tuition, or similar documents will not be accepted.

The EUTF will mail a courtesy reminder letter two months prior to your dependent’s birthday.  Student certification must be submitted to the EUTF within 15 days of the dependent’s birthday in order to avoid termination of their dental and/or vision plans.  If EUTF does not receive student certification prior to the end date listed on the courtesy reminder, a COBRA Election Notice will generate and coverage will stop at the end of that pay period.  In order to maintain enrollment, student certification must be renewed annually.

EUTF Administrative Rules 1.02 and 5.05(b) specify that dependent-beneficiaries ages 19 through 23 who are full-time students may enroll in dental and/or vision plans.  Children may be enrolled in medical and prescription drug plans until age 26 regardless of whether they are a full-time student or not.

I’m a new State or County employee and want to learn more about my health plan options. Is there educational material available?

Yes.  An on-demand video is available that covers enrollment procedures, eligibility criteria and a summary of EUTF health plan options and other benefits.  For more information, you can also download the EUTF New Hire Enrollment Guide.

Why did I receive a COBRA General Notice in the mail?

You will receive a COBRA General Notice if you make changes to your plan enrollment.  This notice contains information about your right to COBRA continuation coverage, which is a temporary extension of coverage under EUTF plans when coverage under the plan would normally cease.  This notice generally explains COBRA continuation coverage, when it may become available to you and your family, and what you need to do to protect the right to receive it.  For more information on COBRA, click here.

Why did I receive a COBRA Election Notice?

The COBRA Election Notice offers employees and/or their dependents temporary continuation of their health plan coverage when their coverage would otherwise end because of certain qualifying events (i.e., end of employment, child ceasing to be an eligible dependent child, etc.).  The maximum period of COBRA coverage is generally either 18 or 36 months, depending on which qualifying event occurred.  To watch a short overview on COBRA, click here.

Who is eligible for active employee health benefits?

Active employees include those who are employed by the State or County who will be working for more than three months in a position that requires more than 50% full-time equivalent.  As an active employee you are eligible to enroll:

  • Yourself
  • Your spouse or domestic partner
  • Your children under age 26 for medical and prescription drug coverage.  This includes children by birth, marriage, adoption, placement for adoption or foster child.  For dental and vision coverage, dependent children under age 19, and from age 19 through age 23 if they are unmarried and a full-time student.  For children covered under legal guardianship, their coverage will terminate at 18.
  • Your child, regardless of age, who are incapable of self-support because of a mental or physical impairment that existed prior to the child reaching age 19.

Part-time and temporary employees not eligible for the EUTF health plans should contact their departmental human resources or personnel office for more information.

I’m having a baby. What do I need to do to enroll my baby in my health plans?

Complete an EC-1 enrollment form (or EC-1H for HSTA VB members) and submit it to your departmental human resources office or enrollment designee within 180 days of the baby’s birthday.  For DOE employees, you must submit your form to:

DOE-EBU
PO Box 2360
Honolulu, HI 96804

A copy of the birth certificate is required only if the child has a different last name than you.  You can add your baby to your current plans – you cannot change plans.  Please submit your child’s Social Security Number to the EUTF once it’s issued by the Social Security Administration.  For more information, please see the Newborn Checklist.

If I have a baby, can I also enroll my spouse/partner to the plan?

Yes.  To enroll your spouse/partner, add their information to the EC-1 enrollment form (or EC-1H for HSTA VB members) and submit it to your departmental human resources office or enrollment designee within 180 days of the baby’s birthday.  For DOE employees, you must submit your form to:

DOE-EBU
PO Box 2360
Honolulu, HI 96804

If you are enrolling your spouse/partner for the first time in EUTF plans, please submit a copy of your marriage certificate or domestic partnership documents. You can add your spouse to your current plans – you cannot change plans.

I’m getting married and want to add my spouse. What do I need to do?

Complete an EC-1 enrollment form (or EC-1H for HSTA VB members) and submit it to your departmental human resources office or enrollment designee within 30 days of your marriage date.  For DOE employees, you must submit your form to:

DOE-EBU
PO Box 2360
Honolulu, HI 96804

Attach a copy of your marriage certificate or if it’s not available within 30 days, send it to the EUTF within 60 days of your marriage date.  You can add your spouse to your current plans – you cannot change plans.

I’m getting divorced and I’m covered under my spouse’s non-EUTF plan. What should I do?

Complete an EC-1 enrollment form (or EC-1H for HSTA VB members) and submit it to your departmental human resources office or enrollment designee within 30 days of your loss of coverage under your spouse’s plan.  For DOE employees, you must submit your form to:

DOE-EBU
PO Box 2360
Honolulu, HI 96804

Attach a loss of coverage letter from your former spouse’s employer or the health benefits carrier detailing the type of coverage lost, the date of loss, and the names of who lost coverage.  Your effective date of coverage under EUTF plans is the day following your loss of coverage under your former spouse’s plan.

I’m getting divorced and my spouse is covered under my EUTF plans. What should I do?

Employees must terminate their spouse’s/partner’s coverage within 30 days of the date of divorce.  Complete an EC-1 enrollment form (or EC-1H for HSTA VB members) and submit it to your departmental human resources office or enrollment designee within 30 days of your divorce date to terminate your spouse’s coverage.  For DOE employees, you must submit your form to:

DOE-EBU
PO Box 2360
Honolulu, HI 96804

Attach pages 1 and 2 of the divorce decree along with the signature page.  If the EC-1/EC-1H is filed more than 60 days after the date of divorce, the employee will be responsible for paying the employer contribution of premiums retroactive to the divorce date.  Your former spouse’s coverage ends the first date of the first pay period following the divorce.

I was covered under my spouse’s health insurance and we recently lost our coverage. Can I enroll into my EUTF coverage right away?

Yes.  Complete an EC-1 enrollment form (or EC-1H for HSTA VB members) and submit it to your departmental human resources office or enrollment designee within 30 days from the date you lost coverage under your spouse’s plan.  For DOE employees, you must submit your form to:

DOE-EBU
PO Box 2360
Honolulu, HI 96804

Attach a loss of coverage letter from your spouse’s employer or the health benefits carrier detailing the type of coverage lost, the date of loss, and the names of who lost coverage.  Your effective date of coverage under EUTF plans is the day following your loss of coverage under your spouse’s plan.

What are my options for insurance coverage when I’m on leave without pay?

If your leave without pay (LWOP) is expected to last longer than 30 days, you have two options:

  1. Cancel your health benefit plan enrollment during your leave of absence.
    • You must complete an EC-1 enrollment form (or EC-1H for HSTA VB members) within 30 days from your authorized leave date to cancel coverage, and may enroll in the same health plans upon return from leave by submitting an EC-1/EC-1H form within 30 days from your return date. The effective date of the cancellation will be the first day of the first pay period following your LWOP start date.
  2. Continue all your plans during your leave of absence by paying the premiums due by the end of the month.
    • Employees are responsible for submitting premium payments to the EUTF by check, electronic check, credit card or ACH payment. For more information on premium payment options, please click here.

If you do not submit an EC-1/EC-1H enrolment form within 30 days to cancel your coverage and do not make payment to the EUTF, your plans will be cancelled due to non-payment.  You may enroll during the next open enrollment or if you experience a qualifying life event.

If you are on leave without pay for a period less than 30 days, you could still have a premium shortage.  Employees on leave should check their paystub to see if they need to submit a premium payment to the EUTF.

For employees on Family Medical Leave of Absence without pay:  If you continue plans but do not submit payment to the EUTF by the due date indicated on the Shortage notice, your plans will be cancelled effective the due date on the notice.

For Uniformed Services Employment and Reemployment Rights Act (USERRA): If you continue plans but do not submit payment to the EUTF by the due date indicated on the shortage notice, your plans will be cancelled retroactive to your leave of absence date.

My dependent is no longer eligible (i.e., divorce, legal separation or dissolution of domestic partnership, etc.). Do I need to notify the EUTF?

Divorced or legally separated spouse/civil union partners, or domestic partners whose partnership has been dissolved are no longer eligible for EUTF plans, regardless of whether your divorce decree indicates that coverage must be afforded to your spouse.  You must notify the EUTF within 30 days from the divorce or legally separated filing dates or date of the termination of domestic partnership and terminate your dependent’s coverage.

Complete an EC-1 enrollment form (or EC-1H for HSTA VB members) and submit it to your departmental human resources office or enrollment designee within 30 days to remove your dependent from your EUTF plans.  For DOE employees, you must submit your form to:

DOE-EBU
PO Box 2360
Honolulu, HI 96804

Your dependent will be terminated the first day of the first pay period following their loss of eligibility.  If the EC-1/EC-1H is filed more than 60 days after the date of divorce/partnership, the employee shall be responsible for paying the employer contribution of premiums retroactive to the divorce date.

My child is no longer eligible (i.e., graduated from college, is no longer a full-time student, etc.), but is under age 24. Do I need to notify the EUTF?

You must notify the EUTF and terminate your child’s dental and vision coverage within 30 days from when they become ineligible.  This does not apply to medical and prescription drug coverage, which they may remain enrolled in to age 26.

Complete an EC-1 enrollment form (or EC-1H for HSTA VB members) and submit it to your departmental human resources office or enrollment designee within 30 days to remove your dependent from your EUTF plans.  For DOE employees, you must submit your form to:

DOE-EBU
PO Box 2360
Honolulu, HI 96804

Your child will be terminated the first day of the first pay period following their loss of eligibility.

How do I change my address?

Complete an Employee Address Change Form and submit it to your departmental human resources office or enrollment designee as soon as possible. For DOE employees, you must submit your form to:

DOE-EBU
PO Box 2360
Honolulu, HI 96804

The EUTF will process your change of address and notify each of the health plan carriers.   Be advised that all address changes must go through the EUTF and not to the health plan carriers directly.

Will I get new health plan ID cards every year?

No.  ID cards are only issued for new enrollments or when you make changes to your plan enrollment.  ID cards are not issued for HMA, American Specialties Health Group Inc., and VSP, as ID cards are not required to receive services.

Where can I get more information on EUTF plan options for active employees, enrollment procedures and eligibility criteria?

The EUTF Reference Guide for Active Employees is published annually and contains information on enrollment and eligibility, premiums and contributions, health plan options and how to make changes to your plans.  To download the guide, click here and select the Reference Guide you wish to view.

Does EUTF offer the Island Flex Plan?

No.  For State employees, the Island Flex Plan is administered by the State Department of Human Resources Development (DHRD).  For more information, please visit the website of the plan’s third-party administrator, Comprehensive Financial Planning, Inc. at http://www.CompFinPlan.com.  For County employees, contact your personnel office for more information.

Where can I get more information on the Premium Conversion Plan?

For State employees, the Premium Conversion Plan (PCP) is a voluntary benefit plan, administered by the State Department of Human Resources Development (DHRD) that allows employees to pay their health benefit plan premiums on a pretax basis and is being offered pursuant to Section 125 of the Internal Revenue Code. For more information click here.  For County employees, contact your personnel office for more information.

I’m an active employee considering retirement. Where can I learn more about what is needed to enroll in EUTF retiree plans?

Sign-up to attend a pre-retirement health benefits workshop, watch an on-demand pre-retirement informational video, or view the Pre-retirement Checklist and Medicare Checklist.

If I’m killed in the performance of duty, what will happen to my family’s health coverage?

The surviving spouse/partner of an employee killed in the performance of duty is eligible to enroll in retiree plans, provided the spouse or partner does not remarry or enter into another domestic or civil union partnership.  Additionally, the unmarried child of an employee killed in the performance of duty is eligible to be enrolled in retiree plans, provided the child is under the limiting age, as defined in the EUTF Administrative Rule 1.02 or is an adult disabled child in accordance with the EUTF Administrative Rule 3.01(b)(3) and does not have a surviving parent who is eligible to be an employee-beneficiary.

If I die before I retire, is my spouse/partner eligible for EUTF health coverage?

The surviving spouse/partner and/or unmarried child of a deceased employee is eligible to enroll in EUTF retiree plans provided the deceased employee was eligible on his/her date of death to retire with the Employees’ Retirement System (ERS).  In order to continue enrollment in EUTF retiree plans, the surviving spouse/partner may not remarry or enter into another domestic or civil union partnership.  The surviving child of a deceased employee is eligible to enroll in retiree plans provided the child is under the age of 19 and does not have a surviving parent who is eligible to be an employee-beneficiary.

HSTA VB Retiree

I’ve recently retired and enrolled in EUTF retiree health plans. Why am I receiving COBRA Continuation of Benefits Enrollment material?

For retirees who were enrolled in EUTF Active plans at the time of their retirement, once the EUTF receives an EC-1 form from your employer to terminate your active coverage, you will receive a COBRA Continuation of Coverage Election Notice from the EUTF.  COBRA allows you to continue some or all of your Active EUTF health plans.  Keep in mind that if you elect COBRA, you will be responsible for 110% of the premium cost.  The EUTF is required by federal law to offer COBRA to members who terminate EUTF health plans.

Click for more information about COBRA for retirees.

I am enrolled in EUTF retiree health plans and will be eligible for Medicare in a few months. What do I need to do?

The Hawaii Revised Statutes 87A-23(4) requires that State and County retirees and their eligible dependents who are enrolled in EUTF retiree medical and/or prescription drug benefit plans, must be enrolled in Medicare Part B when they become eligible.  Please provide proof of Medicare Part B enrollment to the EUTF within 60 days of becoming eligible.  If you and/or your covered dependent(s) are Medicare eligible and covered under EUTF retiree medical and/or prescription drug plans you must submit a copy of your and/or your dependent’s Medicare card (indicating enrollment into Medicare Part B), Medicare Part B Reimbursement Direct Deposit Agreement Form, and Social Security Administration letter for you and/or your dependent indicating the Medicare Part B Premium amount.  If you do not provide proof of Medicare Part B enrollment to the EUTF within 60 days of becoming eligible, your and/or your dependent’s EUTF retiree medical and/or prescription drug plans will be cancelled.

Click for a copy of the EUTF Medicare Checklist.

I pay a monthly premium for my EUTF retiree health plans. What are my premium payment options other than mailing in my payment to the EUTF?

If you are currently paying your healthcare premiums via check to the EUTF, you now have four other payment options:

  1. Premiums automatically deducted each month from your Employees’ Retirement System (ERS) pension.
  2. Monthly reoccurring electronic transfers from your bank account initiated and adjusted by the EUTF.
  3. Credit card for a fee of $2.50 plus 2.25% of the premium amount.
  4. Electronic transfers from your bank account that you initiate for a fee of $3.50 per transaction.

Click to initiate payment transactions or for more information.

How do I change my address?

Retirees may complete and submit a Retiree Address Change Form.  Once the Retiree Address Change Form is received, the EUTF will notify the health carriers of your new address. Be advised that all address changes must go through the EUTF, as health plan carriers are not able to make changes.

Where can I get more information on EUTF plan options for retirees, enrollment procedures and eligibility criteria?

The Health Benefits Retiree Reference Guide is published annually and mailed to retirees in the Fall.  The Reference Guide contains information on EUTF policies and procedures, enrollment and eligibility, employer contribution, health plan options, the EC-2 enrollment form, and Common Qualifying Events chart.

Do I need to turn in my Income-Related Monthly Adjustment Amount (IRMAA) to get reimbursement for Medicare Part B?

Yes.  The EUTF will need a copy of your Medicare card, Direct Deposit Agreement Form, and Social Security Administration letter indicating your Medicare Part B premium or IRMAA.  EUTF will automatically reset your Medicare Part B premium reimbursement to the Medicare standard amount every January 1st. If you are paying above the Medicare standard amount you must submit a letter from the Social Security Administration indicating the amount you are paying every year to receive full reimbursement.

Will I be reimbursed for Medicare Part D premiums if I’m being charged by Social Security?

No, EUTF is not authorized under Hawaii Revised Statutes 87A to reimburse Medicare Part D premiums.

Can I change plans if I move out of the coverage area?

You may change plans if you are enrolled in the EUTF retiree Kaiser plan and move out of the service area. You have 30 days to notify EUTF and may switch to the HMSA 90/10 plan.  Please complete an EC-2 enrollment form (or EC-2H for HSTA VB members) and submit it to the EUTF within 30 days of moving out of the coverage area.

Does my spouse or I need to be covered under an EUTF active employee plan at the time of retirement to be eligible to enroll in the EUTF retiree plans?

No, you do not need to be enrolled in Active plans for any amount of time or be enrolled in the EUTF Active plan at all to qualify for EUTF retiree benefits.

If I retire from the State or County and later return to work for the State or County, do I need to notify the EUTF?

Yes, if you return to work full-time for the State or County you must notify the EUTF to stop your EUTF retiree plans and you may enroll in EUTF Active plans.  If you return to work part-time or outside of the State or County, this does not apply to you.

I’m getting divorced and my spouse is covered under my EUTF plans. What should I do?

Retirees must terminate their spouse’s/partner’s coverage within 30 days of the date of divorce.  Complete an EC-2 enrollment form (or EC-2H for HSTA VB members) and submit it to the EUTF within 30 days of your divorce date to terminate your spouse’s coverage.  Attach pages 1 and 2 of the divorce decree, along with the signature page.

If the EC-2/EC-2H is filed more than 60 days after the date of divorce, the retiree will be responsible for paying the employer contribution of premiums retroactive to the divorce date.

I’m getting married and want to add my spouse. What do I need to do?

Complete an EC-2 enrollment form (or EC-2H for HSTA VB members) and submit it to the EUTF within 30 days of your marriage date.  Attach a copy of your marriage certificate or if it’s not available within 30 days, send it to the EUTF within 60 days of your marriage date.  You can add your spouse to your current plans – you cannot change plans.

My dependent is no longer eligible (i.e., divorce, legal separation or dissolution of domestic partnership, etc.). Do I need to notify the EUTF?

Divorced or legally separated spouse/civil union partners, or domestic partners whose partnership has been dissolved are no longer eligible for EUTF plans, regardless of whether your divorce decree indicates that coverage must be afforded to your spouse.  You must notify the EUTF within 30 days from the divorce or legally separated filing dates or date of the termination of domestic partnership and terminate your dependent’s coverage.

Complete an EC-2 enrollment form (or EC-2H for HSTA VB members) and submit it to the EUTF within 30 days to remove your dependent from your EUTF plans.  If the EC-2/EC-2H is filed more than 60 days after the date of divorce/partnership, the retiree shall be responsible for paying the employer contribution of premiums retroactive to the divorce date.

My child is no longer eligible (i.e., graduated from college, no longer a full-time student, etc.), but is under the age of 24. Do I need to notify the EUTF?

You must notify the EUTF and terminate your child’s medical, prescription drug, dental and vision coverage within 30 days from when they become ineligible.

Complete an EC-2 enrollment form (or EC-2H for HSTA VB members) and submit it to the EUTF within 30 days to remove your dependent from your EUTF plans.

My spouse passed away. What do I need to do?

Please see the Death checklist for more information.

What and when is open enrollment?

Open Enrollment is your opportunity to make changes to your plan enrollment.  During Open Enrollment you can:

  • Add, change or cancel plans
  • Add or remove dependents
  • Change coverage tiers such as changing from single to family, or family to two party

You will be mailed a Retiree Reference Guide which will notify you of the upcoming Open Enrollment period.  Please make sure that your address is current so that you don’t miss out on this and other EUTF communications.  Open Enrollment usually takes place in the month of October and plan and premium changes become effective Jan. 1st.

How and when will I be reimbursed for my Medicare Part B premiums?

The following must be submitted to the EUTF in order to receive reimbursement of Medicare Part B premiums:

  1. Copy of your Medicare card indicating enrollment in Medicare Part B
  2. Medicare Part B Premium Reimbursement Request and Direct Deposit Agreement Form
  3. Social Security Administration letter indicating the amount of your monthly Medicare Part B premium

Under current law, the amount of your Medicare Part B reimbursement is the amount you are charged by Medicare (minus any penalties). Generally, your reimbursement will be deposited quarterly during the first week of April, July, October and January for the prior quarter.

Why am I required to enroll in Medicare Part B when I am eligible?

The requirement for all State and County retirees and dependents to enroll in Medicare Part B was set forth in Act 88, 2001 Session Laws of Hawaii. This Act created Chapter 87A, Hawaii Revised Statutes (HRS), which includes the following statute:

 Section 87A-23(4): “All employee-beneficiaries or dependent-beneficiaries who are eligible to enroll in the Medicare Part B medical insurance plan shall enroll in that plan as a condition of receiving contributions and participating in benefits plans under this chapter. This paragraph shall apply to retired employees, their spouses or, and the surviving spouses of deceased retirees and employees killed in the performance of duty;”

Who is eligible for retiree health benefits?

As a State or County retiree, you are eligible to enroll:

  • Yourself
  • Your spouse, or domestic or civil union partner
  • Your children under age 19.  Children under age 24 if unmarried and a full-time student.  Dependent children include those by birth, marriage, foster, adoption or placement for adoption
  • Your child, regardless of age, who is incapable of self-support because of a mental or physical impairment that existed prior to the child reaching age 19.

In addition, the following persons are eligible for Retiree health benefits:

  • The surviving spouse of an employee killed in the performance of the employee’s duty, provided he or she does not enter into another marriage or domestic partnership
  • The surviving spouse of a deceased retiree or a deceased employee who at the time of death was eligible for retirement, provided he or she does not enter into another marriage or domestic partnership
  • The unmarried child of a deceased retired employee, provided the child is under age 19 with no surviving parent who is eligible to be covered as a surviving spouse