Retirees – Open Enrollment

Open Enrollment

Open Enrollment runs from October 16 – October 31, 2023.
The elections you make during this period will be effective January 1 – December 31, 2024.

EUTF Retiree Highlights Guide (including enrollment forms) will be mailed to your address on file in mid-October.
Open enrollment is the time to decide if your (and your dependents’) current health coverage will meet your needs for 2024. Starting Monday, October 16 through Tuesday, October 31, 2023, 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 2024.

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: Tuesday, October 31, 2023.
  4. Your plan elections and changes will be effective January 1 – December 31, 2024.
Note: The EUTF will not contact you if you are missing supporting documents. Any submission after October 31, 2023 will not be accepted.
Required Supporting Documents
Enrollment Type
Required Documents
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
  • Student Certification from accredited school with registrar’s signature confirming full-time status or certificate from the National Student Clearinghouse (Transcripts not accepted)

2024 EUTF Retiree Highlights Guide (PDF)
2024 EC-2 Enrollment Form (PDF)
2024 EC-2H Enrollment Form (PDF)