Retirees – Open Enrollment

Open Enrollment


Open Enrollment runs from October 14 – October 31, 2024.
The elections you make during this period will be effective January 1 – December 31, 2025.

The EUTF Retiree Highlights Guide (including enrollment forms) was mailed to retirees at the end of September.
Open enrollment is the time to decide if your (and your dependents’) current health coverage will meet your needs for 2025. Starting Monday, October 14 through Thursday, October 31, 2024, you can:

  • Add, change, or drop a health plan
  • Add or remove one or more dependents
  • Change coverage tiers (e.g., if you move from Self to Family or Family to Two-Party coverage).
If you don’t want to make changes to your current plan elections:
You don’t need to take any action or complete any forms to continue your current plan elections in 2025.

If you want to make changes to your current plan elections:

  1. Complete an EC-2 enrollment form (or EC-2H for retirees enrolled in HSTA VB benefit plans) and gather required supporting documents.
  2. Deliver in-person to the EUTF or submit by U.S. mail to EUTF, 201 Merchant Street Suite 1700, Honolulu, HI 96813.
  3. Deadline for postmark or in-person delivery: Thursday, October 31, 2024.
  4. Your plan elections and changes will be effective January 1 – December 31, 2025.
Note: The EUTF will not contact you if you are missing supporting documents. Any submission after October 31, 2024 will not be accepted.
Required Supporting Documents
If you want to…
You’ll need…
Enroll Yourself
  • No documents required
Add a Spouse/Partner
  • Marriage or Civil Union Certificate
  • Domestic Partnership forms and two sets of documents showing shared residency
Add a Dependent Child
  • Birth Certificate
  • Guardianship Decree (if legal guardian)
  • Adoption Decree (if child is placed for adoption or adopted)
Add Dependent Children Ages 19 through 23 (Full-time Students Enrolling in Dental and Vision Plans)
  • Student Certification from accredited school on school letterhead with registrar’s signature or certificate from the National Student Clearinghouse indicating full-time status. (Transcripts and class schedules are not accepted.)

Resources
2025 EUTF Retiree Highlights Guide (PDF)
2025 EC-2 Enrollment Form (PDF)
2025 EC-2H Enrollment Form (PDF)