Hawaii Administrative Rules › Title 24 - HAWAII EMPLOYER-UNION HEALTH BENEFITS TRUST FUND ADMINISTRATIVE RULES › Sec2 1.00 - GENERAL PROVISIONS › Section 24-1.02 - Definitions

Current through June, 2024
As used in these rules, unless otherwise indicated by the
				context, the following terms shall have the following meanings:
"Administrator" means the administrator of the Fund appointed
				by the board or the duly authorized representative of the administrator.
"Benefit plan" means a health benefit plan, a group life
				insurance plan that is subject to Section 79 of the Internal Revenue Code, or
				any other type of benefit plan except for a long-term care benefit plan.
"Board" shall have the meaning as set forth in Section 87 A-1
				of the Hawaii Revised Statutes.
"Cancellation Non-Payment Status" means an employee-beneficiary
				whose plans have been cancelled for the remainder of the plan year due to
				failure to pay the required semi-monthly or monthly contributions.
"Carrier" shall have the meaning as set forth in Section 87 A-1
				of the Hawaii Revised Statutes.
"Child" means an employee's, spouse's or partner's as defined
				in these rules, legally adopted child, child placed for adoption, stepchild,
				foster child, or recognized natural child. For excepted benefits, a child must
				be unmarried and live with the employee-beneficiary. A child has been placed
				for adoption when an employee-beneficiary, spouse, or partner has assumed
				custody of and the obligation to support a child in anticipation of adopting
				the child. A foster child is a child:
(1) who lives with an employee in a regular parent-child
				relationship; and
(2) for whom the employee has become the child's guardian and
				has been awarded legal and physical custody of the child pursuant to a valid
				court order.
"Civil Union Partner" means an individual who is a party to a
				civil union established pursuant to Chapter 572B of the Hawaii Revised
				Statutes.
"Contribution" or "Contributions" shall have the meaning as set
				forth in Section 87 A-1 of the Hawaii Revised Statutes.
"County" shall have the meaning as set forth in Section 87 A-1
				of the Hawaii Revised Statutes.
"Dependent-beneficiary" shall mean the persons described in
				Rule 3.01 of these rules as being eligible for coverage as
				dependent-beneficiaries in the health benefit plans offered or sponsored by the
				Fund.
"Dissolution of domestic partnership" shall occur when: (1) the
				employee-beneficiary no longer meets the requirements to qualify as a "domestic
				partner"; (2) one of the partners to the domestic partnership expressly informs
				the other of the end of their domestic partnership; (3) one of the partners to
				the domestic partnership takes actions inconsistent with the continued
				existence of the domestic partnership; or (4) the domestic partnership is
				otherwise terminated or dissolved.
"Domestic partner" shall mean a person in a spouse-like
				relationship with an employee-beneficiary who meets the following requirements:
				(1) the employee-beneficiary and the domestic partner intend to remain in a
				domestic partnership with each other indefinitely; (2) the employee-beneficiary
				and the domestic partner have a common residence and intend to reside together
				indefinitely; (3) the employee-beneficiary and the domestic partner are and
				agree to be jointly and severally responsible for each other's basic living
				expenses incurred in the domestic partnership such as food, shelter and medical
				care; (4) neither the employee-beneficiary nor the domestic partner are married
				or a member of another domestic partnership; (5) the employee-beneficiary and
				the domestic partner are not related by blood in a way that would prevent them
				from being married to each other in the State of Hawaii; (6) the
				employee-beneficiary and the domestic partner are both at least 18 years of age
				and mentally competent to contract; (7) the consent of the employee-beneficiary
				or the domestic partner to the domestic partnership has not been obtained by
				force, duress or fraud; and (8) the employee-beneficiary and the domestic
				partner sign and file with the Fund a declaration of domestic partnership in
				such form as the board shall from time to time prescribe.
"Eligibility" shall have the meaning as meeting the Fund's
				requirements to participate or be qualified to participate in plans offered by
				the Fund.
"Employee" shall have the meaning as set forth in Section 87
				A-1 of the Hawaii Revised Statutes.
"Employee-beneficiary" shall mean the persons described in Rule
				3.01 of these rules as being eligible to enroll as employee-beneficiaries in
				the health benefit plans offered or sponsored by the Fund.
"Employer" or "public employer" shall have the meaning as set
				forth in Section
				89-2 of the Hawaii
				Revised Statutes.
"Excepted Benefits" shall mean benefits not subject to the
				National Health Care Reform Law (including the Patient Protection and
				Affordable Care Act [PPACA] of 2010, the Public Health and Safety Act, the
				Health Care and Education Reconciliation Act [HCERA] of 2010, and all
				subsequent legislative amendments and guidance). Examples of 'excepted
				benefits' include stand alone dental and vision plans and retiree-only
				plans.
"Full-time student" means a student who is enrolled in an
				accredited school, college, or university for not less than the minimum number
				of credit hours required by such educational institution to have full-time
				student status.
"Fund" shall have the same meaning as set forth in Section
				87A-1 of the Hawaii
				Revised Statutes.
"Fund benefit plan" means a benefit plan offered or sponsored
				by the Fund.
"Health benefit plan" shall have the same meaning as set forth
				in Section 87 A-1 of the Hawaii Revised Statutes.
"Limiting Age" shall mean: (1) for active employees, pertaining
				to excepted benefits, as defined in this Rule 1.02, the age a child loses
				eligibility as a dependent-beneficiary is upon reaching age nineteen, unless
				the child is a full-time student, as defined in this Rule 1.02, which would
				extend the limiting age to the child's twenty-fourth birthday; (2) for active
				employees, pertaining to non-excepted benefits, as defined in this Rule 1.02,
				the age at which a child loses eligibility as a dependent-beneficiary is upon
				the end of the month that the dependent reaches age twenty-six; (3) for
				retirees, pertaining to non-excepted and excepted benefits, as defined in this
				Rule 1.02 the age a child loses eligibility as a dependent-beneficiary is upon
				reaching age nineteen, unless the child is a full-time student, as defined in
				this Rule 1.02, which would extend the limiting age to the child's
				twenty-fourth birthday.
"Long-term care benefits plan" shall have the same meaning as
				set forth in Section
				87A-1 of the Hawaii
				Revised Statutes.
"Month" shall mean thirty (30) days.
"Non-Fund benefit plan" means a benefit plan offered or
				sponsored by a private employer or an entity other than the Fund.
"Part-time, temporary, and seasonal or casual employee" shall
				have the same meaning as set forth in Section 87 A-1 of the Hawaii Revised
				Statutes.
"Partner" or "Partnership" shall mean a domestic partner or
				civil union partner.
"Periodic change" shall have the same meaning as set forth in
				Section
				87A-1 of the Hawaii
				Revised Statutes.
"Plan year" shall mean the 12-month period from January 1
				through December 31 for retired employees and July 1 through June 30 for active
				employees.
"Qualified-beneficiary" shall have the meaning as set forth in
				Section 87 A-1 of the Hawaii Revised Statutes.
"Qualified medical child support order" means any judgment,
				decree, or order issued by a court of competent jurisdiction that requires the
				provision of health benefits coverage to a child of a non-custodial
				parent.
"Retired member" or "retired employee" means a former employee,
				officer, appointed or elected official of the State or counties who is
				currently receiving a retirement or pension allowance from a State or county
				retirement system or an employee who retired prior to 1961.
"Spouse" means a person who is lawfully married pursuant to
				Hawaii law".
"State or county retirement system" means the employees'
				retirement system, the county pension system, or the police, fire, or bandsmen
				pension system of the State or any county.
"Termination of civil union partnership" means the civil union
				partnership terminates in accordance with applicable state laws and
				rules.
"Trustee" shall have the meaning as set forth in Section 87 A-1
				of the Hawaii Revised Statutes.
"Trustee group" means the group composed of the five trustees
				representing public employers or the group composed of the five trustees
				representing employee-beneficiaries as described in Section
				87A-5 of the
				Hawaii Revised Statutes.