Hawaii Employer-Union Health Benefits Trust Fund

(All applicable to the EUTF non-Medicare retiree plan only)

1. Added the anti-psychotic class to the Generic Step Therapy Program effective April 1, 2025. Existing members using an anti-psychotic drug will be grandfathered.
2. Implemented the Basic Control Formulary effective July 1, 2025, where utilization management was added to non-preferred products in ten specific drug classes.
3. Implemented Hyperinflation Management effective July 1, 2025, where hyperinflated drugs that have readily available, clinically appropriate and more cost-effective alternatives are excluded.
4. Revised prior authorization criteria for antidiabetic GLP-1s and added a cumulative fill edit on antidiabetic and weight loss GLP-1s simultaneously effective July 1, 2025. Antidiabetic GLP-1s include Ozempic, Mounjaro, Rybelsus, Trulicity, and Victoza, and weight loss GLP-1s include Wegovy and Zepbound.
5. Added prior authorization requirements for non-specialty dermatologic products effective January 1, 2026. Existing members using a non-specialty dermatologic product will be grandfathered and will not need to obtain prior authorization.
6. Added coverage of continuous glucose monitors and disposable insulin pumps at the existing diabetic supply cost share under the EUTF and HSTA VB non-Medicare retiree plans effective July 1, 2026. Prior authorization required. Coverage is provided under the HMSA medical plan if received from a durable medical equipment provider and under the CVS drug plan if received from a pharmacy. There is no coordination of benefits between the EUTF HMSA and CVS plans.