Active Employees – Open Enrollment

Open Enrollment

Open Enrollment
Open Enrollment (OE) is the time for you to review whether the health coverage you have for yourself and your family continues to best meet your needs. The OE election period is April 1 – May 14, 2021.
During the OE election period, you can:

  • Add a plan, change from one plan to another, or drop a plan
  • Add an eligible dependent or remove a dependent
  • Change coverage tiers, such as changing from Self to Family or Family to Two-Party
If you decide to keep your current plans, you don’t need to take action. You are not required to complete any forms to continue your current coverage.
If you are making changes, complete and submit the EC-1 (or EC-1H for those enrolled in HSTA VB benefit plans) enrollment forms.


Important Dates
Open Enrollment Dates
Open Enrollment Election Period
April 1 – May 14, 2021
Enrollment Forms and Supporting Documents Submission Deadline
May 14, 2021
New Coverage and Rate Changes
Premium and Plan Changes Effective Date
July 1, 2021
For County Employees
New Premium Deducted from Paychecks
July 15, 2021 through June 30, 2022
For State Employees
New Premium Deducted from Paychecks
July 20, 2021 through July 5, 2022
Benefit Periods
Plan Year Benefit Period
July 1, 2021 through June 30, 2022
Calendar Year Benefit Period
January 1, 2021 through December 31, 2021
and January 1, 2022 through December 31, 2022
Do NOT submit form to the EUTF. Submit EC-1/1H forms to your:
– Departmental Human Resources Office
– County Personnel Office
– DOE-EBU, PO Box 2360, Honolulu, HI 96804 (DOE Employees)
– Enrollment Designee


  • Open Enrollment Informational Session (Video) (PDF)
  • Employee Health Benefits Reference Guide (PDF)
  • Summary of Benefits and Coverage EUTF | HSTA VB
  • Open Enrollment Webinar Session Schedule (PDF)
  • Active Employee Memo to Employers and Employees (PDF)
  • Open Enrollment Checklist (PDF)
  • EC-1 (Non-Ratified BU’s) Form (PDF)
  • EC-1 (Ratified BU’s) Form (PDF)
  • EC-1H Form – HSTA VB (PDF)
EUTF Active Employee Premium Plan Comparison Tool
– Compare 2021 premiums between your current plan and 2 additional plans.
Premium Plan Comparison Tool
EUTF Plan Finder
– Determine which Benefit Plans you are currently enrolled in based on the amounts from your pay stub.
EUTF Plan Finder
EUTF Active Employee Rates and Contributions

  • BU 00, 01, 02, 03, 04, 05, 07, 08, 10, 13, 14, and Employees Excluded from All Bargaining Units (PDF)
  • BU 06, 09, 11, 12, and 15 (PDF)
  • HSTA VB BU 05 (PDF)