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 3 – May 12, 2023.
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 form and required supporting documents to your employer’s open enrollment designee by May 12, 2023. The EUTF will not contact you regarding outstanding supporting documents and late submissions will not be accepted.
For more information, please review the 2023 Employee Health Benefits Reference Guide.


Required Supporting Documents
Enrollment Type
Required Documents
Self
No documents required
Adding a Spouse/Partner
  • Marriage or Civil Union Certificate
  • Domestic Partnership forms
Adding a Dependent Child
  • Birth Certificate
  • Guardianship Decree (if legal guardian)
  • Adoption Decree (if child is placed for adoption or adopted)
Dependent Children Ages 19 through 23 (Full-Time Students Enrolling in Dental and Vision Plans)
  • Student Certification from accredited school with registrar’s signature confirming full-time status or certificate. (Transcripts not accepted)


Important Dates
Open Enrollment Dates
Open Enrollment Election Period
April 3 – May 12, 2023
Enrollment Change Requests and Supporting Documents Submission Deadline
May 12, 2023
New Coverage and Rate Changes
Premium and Plan Changes Effective Date
July 1, 2023
For County Employees
New Premium Deducted from Paychecks
July 15, 2023 through June 30, 2024
For State Employees
New Premium Deducted from Paychecks
July 20, 2023 through July 5, 2024
Benefit Periods
Plan Year Benefit Period
July 1, 2023 through June 30, 2024
Calendar Year Benefit Period
January 1, 2023 through December 31, 2023
and January 1, 2024 through December 31, 2024
Deadline to submit forms and all required supporting documents is May 12, 2023
Do NOT submit forms to the EUTF. Submit EC-1/1H forms and required supporting documents to your:

  • Departmental Human Resources Office
  • County Personnel Office
  • DOE-EBU, PO Box 2360, Honolulu, HI 96804 (DOE Employees)
  • Enrollment Designee



Resources
Employee Health Benefits Reference Guide (PDF)
Open Enrollment Informational Session Schedule (PDF)
Open Enrollment Flier (PDF)
2023-24 EC-1 Enrollment Form (PDF)
2023-24 EC-1H Enrollment Form for HSTA VB (PDF)
EUTF Active Employee Premium Plan Comparison Tool
– Compare 2023 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