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:

The Hawaii Employer-Union Health Benefits Trust Fund (EUTF) is pleased to announce that starting January 31, 2018, retirees that pay 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:

If your form is received before November 30, 2017, your deduction may begin January 31, 2018 (unless you are not currently receiving your pension). Beginning December 1, 2017, if your completed form is received by the 10th day of a month, then deductions from your account will begin the second month after receipt of your completed form. If your completed form is received after the 10th of a month, then your deductions will begin 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 (ERSD-002). If we receive your completed form by the 10th day of a month, then your automatic payments will stop the month after we receive your completed ERSD-002. Otherwise, your automatic payments will stop the second month after we receive your completed form.

If you have previously completed the Automated Clearing House (ACH) Deduction Authorization Agreement and the EUTF is electronically deducting your share of healthcare premiums from your bank account, this will replace such deductions. The EUTF will coordinate termination of the electronic deductions from your bank account with the start of the ERS pension deduction so that a break in payment would be limited, if any.

This payment option allows you to deduct monthly premiums directly from your checking or savings account.  Download the ACH Deduction Authorization Agreement Form

If withdrawing from a checking account, please be sure to attach a VOIDED check to the form.  Deductions from your account will begin the 1st of the month following receipt of your completed form.  However, if we receive your completed form after the 10th of the month, your deductions will begin the 1st of the second month after receipt of your completed form.  (For example, if we receive your form on April 10, 2017, your deductions will begin on May 1, 2017.  If we receive your form on April 11, 2017, your deductions will begin on June 1, 2017)

Please return your completed form to:

You may cancel your automatic payments at any time by completing an ACH Termination Form (ACH-002).  Your automatic payments will stop the month after we receive your completed ACH-002, if received by the 10th of the month.  Otherwise, your deductions will stop the second month after receipt of your completed form.

This service allows you to submit payment for your EUTF health plan premiums by credit card or electronic check (service fees will apply). 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.

Personal check, cashier’s check or money order payments may be made in person at:

or by mail to the EUTF lockbox (P.O. Box 30700, Honolulu, HI 96820-0700).