Hawaii Employer-Union Health Benefits Trust Fund

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), Direct Deposit Agreement Form for Medicare Part B Premium Reimbursement, 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.

A copy of the EUTF Medicare Checklist.