Hawaii Employer-Union Health Benefits Trust Fund

You may use one of the payment options below to submit payment for EUTF health benefit premiums if you are one of the following:

Note: We do not accept COBRA premiums through this payment option. COBRA premium payments should be coordinated with the appropriate insurance carrier(s).

Pay by:

Retirees who pay a portion of their premiums to the EUTF for their medical, prescription drug, dental and vision plans may now choose to have those premiums automatically deducted each month from their Employees’ Retirement System (ERS) Pension.

If you would like to sign up for automatic payment from your ERS Pension, complete the ERS Pension Deduction Authorization Agreement (PD-001) and mail it to:

A completed form received by the 20th day of a month, will be processed for deductions to start in the following month. If your completed form is received after the 20th day of the month, your deductions will start on the third month after receipt of your completed form.

For example:

You may cancel your automatic payments at any time by completing an ERS Pension Deduction Cancellation Form (PD-002). If we receive your completed form by the 20th day of a month, then your automatic payments will stop the month after we receive your completed PD-002. Otherwise, your automatic payments will stop the third month after we receive your completed form.

If you have previously completed the Automated Clearing House (ACH) Deduction Authorization Agreement (ACH-001) and the EUTF is electronically deducting your portion of premiums from your bank account, enrollment into the ERS Pension Deduction will replace your ACH deductions. The EUTF will coordinate the termination of your ACH deductions from your bank account with the start of the ERS pension deduction to minimize a break in payment, if possible.

This payment option allows you to deduct monthly premiums directly from your checking or savings account.

If you would like to sign up for automatic deductions from your bank account, complete the ACH Deduction Authorization Agreement Form (ACH-001) and mail it to:

A VOID check must be attached to the form if your deductions will be taken from your checking account.

A completed form received by the 20th day of a month, will be processed for deductions to start in the current month. If your completed form is received after the 20th day of the month, your deductions will start in the following month after receipt of your completed form.

For example:

You may cancel your automatic payments at any time by completing an ACH Deduction Cancellation Form (ACH-002).  Your automatic payments will stop the month after we receive your completed form, if received by the 20th of the month.  Otherwise, your deductions will stop the second month after receipt of your completed form.

*Exception may be allowed for active employees who are on long-term Leave Without Pay (LWOP) for six months or longer. An Authorized Leave of Absence Without Pay Form (L-1) must be submitted to verify LWOP status.

This service allows you to submit payment for your EUTF health plan premiums by credit card or electronic check (service fees will apply) through a third-party vendor. Debit card is also accepted but will be processed as a credit transaction (service fees will apply). You will be charged a fee of $30 for each returned electronic check due to insufficient funds.

Current fees (subject to change):

• Credit Card – $2.50 convenience fee plus 2.25% credit card fee
• Electronic Check – $2.50 convenience fee plus $1.00 eCheck fee

We also accept personal check, cashier’s check or money order payments in-person at:

or by mail to the EUTF lockbox: