Hawaii Administrative Rules Title 24 - HAWAII EMPLOYER-UNION HEALTH BENEFITS TRUST FUND ADMINISTRATIVE RULES
Hawaii Administrative Rules (HAR)
Title 24 — Hawaii Employer-Union Health Benefits Trust Fund Administrative Rules
Overview and Purpose
Title 24 governs the administration of the Hawaii Employer-Union Health Benefits Trust Fund (EUTF).
The EUTF is a public trust established to provide health, dental, and other benefits to eligible employees and retirees of the State of Hawaii, counties, and participating employers.
These administrative rules provide the framework, policies, and procedures for managing the trust fund, including eligibility, enrollment, benefits, contributions, and appeals.
Key Provisions and Functions
1. Establishment and Governance
The rules describe the creation of the EUTF under state law.
Governance is vested in a Board of Trustees representing employers, employees, and retirees.
The Board oversees policy development, benefit plan design, and financial management.
2. Eligibility and Enrollment
Defines who is eligible for benefits, including:
State and county employees.
Retirees and their dependents.
Other participating employer employees as authorized.
Establishes enrollment periods, required documentation, and procedures for adding or removing participants.
Rules for open enrollment and special enrollment due to qualifying life events are detailed.
3. Benefits and Coverage
Describes the types of benefits provided through the trust fund, which may include:
Medical and hospital insurance.
Prescription drug coverage.
Dental and vision plans.
Other supplemental benefits.
Specifies how benefits are selected, amended, and communicated to participants.
4. Contributions and Funding
Outlines the employer and employee contribution rates.
Describes the collection, accounting, and allocation of contributions to ensure adequate funding of benefits.
Rules on premium payment deadlines, late payments, and consequences of non-payment.
5. Claims and Appeals
Procedures for filing claims for benefits under various plans.
Steps for participants to appeal denied claims or coverage disputes.
Timelines and requirements for appeals, including administrative hearings if necessary.
6. Confidentiality and Records
Policies on the protection of participant information.
Rules for maintaining and disclosing records consistent with privacy laws.
7. Administrative Procedures
Details on meetings, rulemaking, and general administration of the trust fund.
Requirements for reporting, audits, and financial disclosures.
Importance of Title 24 Rules
Ensures the efficient and fair administration of health benefits for public employees and retirees.
Provides clear guidance to participants and administrators on rights, responsibilities, and processes.
Helps maintain the financial stability and sustainability of the benefits trust fund.
Supports compliance with relevant state and federal laws governing employee benefits.
Summary Table
| Aspect | Description |
|---|---|
| Governance | Board of Trustees oversees the EUTF |
| Eligibility | State/county employees, retirees, dependents |
| Benefits | Medical, dental, vision, prescription, supplemental coverage |
| Contributions | Employer and employee funding requirements |
| Claims & Appeals | Procedures for filing and appealing benefit claims |
| Confidentiality | Protection of personal and health information |
| Administration | Meetings, reporting, audits, rulemaking |
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