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State of Hawaii
Hawaii Employer-Union Health Benefits Trust Fund
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About EUTF
Active
EUTF Active
EUTF/HSTA ACTIVE
EUTF Active Members and HSTA Active Members who are enrolled in EUTF plans.
Plan Benefits
HMSA
CVS Caremark
Kaiser Permanente
HMA
HDS
VSP
Securian
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Enrollment Overview
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EUTF Premium Plan Comparison Tool
EUTF Plan Finder
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2022-23 Reference Guide
2023-24 Reference Guide
2022-23 EC-1 Form
2023-24 EC-1 Form
New Hire Enrollment Guide
Pre-Retirement Checklist
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HSTA VB Active
HSTA VB ACTIVE
Hawaii State Teacher's Association Active Members who were enrolled in HSTA VEBA plans previously and maintained continuous enrollment in HSTA VB Plans after the transition to EUTF.
Plan Benefits
HMSA
CVS Caremark
Kaiser Permanente
HDS
VSP
Securian
Premium Conversion Plan
Enrollment & Premiums
Eligibility
Enrollment Overview
Qualifying Events
Premiums & Contributions
EUTF Premium Plan Comparison Tool
EUTF Plan Finder
Forms & Documents
2022-23 Reference Guide
2023-24 Reference Guide
2022-23 EC-1H Form
2023-24 EC-1H Form
New Hire Enrollment Guide
Pre-Retirement Checklist
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Close
Future Retirees
Future Retirees
EUTF FUTURE RETIREE
EUTF Future Retirees who are enrolled in EUTF plans.
Plan Benefits
HMSA
CVS/SilverScript
Kaiser Permanente
Humana
HDS
VSP
Securian
Enrollment & Premiums
Eligibility
Enrollment Overview
Qualifying Events
Premiums & Contributions
Creditable Coverage Notice
Forms & Documents
2023 Retiree Highlights Guide
2023 EC-2 Form
Pre-Retirement Checklist
Medicare Checklist
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Retirees
EUTF Retiree
EUTF RETIREE
EUTF Retirees who are enrolled in EUTF plans.
Plan Benefits
HMSA
CVS/SilverScript
Kaiser Permanente
Humana
HDS
VSP
Securian
Enrollment & Premiums
Eligibility
Enrollment Overview
Qualifying Events
Premiums & Contributions
Creditable Coverage Notice
EUTF Premium Calculators
Forms & Documents
2023 Retiree Highlights Guide
2023 EC-2 Form
Medicare Checklist
Address Change Form
FAQs
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Close
HSTA VB Retiree
HSTA VB RETIREE
Hawaii State Teacher's Association Retirees who were enrolled in HSTA VEBA plans previously and maintained continuous enrollment in HSTA VB Plans after the transition to EUTF.
Plan Benefits
HMSA
CVS/SilverScript
Kaiser Permanente
HDS
VSP
Securian
Enrollment & Premiums
Eligibility
Enrollment Overview
Qualifying Events
Premiums & Contributions
Creditable Coverage Notice
EUTF Premium Calculators
Forms & Documents
2023 Retiree Highlights Guide
2023 EC-2H Form
Medicare Checklist
Address Change Form
FAQs
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Health and Wellness
Learning Center
Medicare
Home
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Retirees
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HSTA VB Retiree
»
HSTA VB Retiree – Premiums & Contributions
Plan Benefits
HMSA
CVS/SilverScript
Kaiser Permanente
HDS
VSP
Securian
Enrollment & Premiums
Eligibility
Enrollment Overview
Qualifying Events
Premiums & Contributions
Creditable Coverage Notice
EUTF Premium Calculators
Forms & Documents
FAQs
HSTA VB Retiree – Premiums & Contributions
January 1, 2023 - December 31, 2023
January 1, 2022 - December 31, 2022
Retiree Worksheet
(PDF)
Retiree Worksheet
(PDF)
Employer Contribution Table
