Hawaii Administrative Rules › Title 12 - DEPARTMENT OF LABOR AND INDUSTRIAL RELATIONS › Chapter 11 - TEMPORARY DISABILITY INSURANCE › Subchapter 1 - GENERAL › Section 12-11-1 - Definitions

Current through June, 2024
As used herein:
"Benefits at least as favorable" means benefits under a plan
				  which meet the requirements of section
				  12-11-16. A plan shall provide
				  each employee, or each employee of the class or classes of employees included
				  under the plan, cash disability "benefits at least as favorable" as the
				  disability benefits under the law.
"Benefit year" shall be as defined in section
				  392-3,
				  HRS.
A "class of employees" for whom benefits are provided under a
				  plan that is submitted for acceptance under section 392-41a)(4) or (5), HRS,
				  shall not be a class determined arbitrarily. In order to constitute a class of
				  employees within the provisions of the statutes, there shall be a reasonable
				  basis of classification including, without limitation, type of work performed,
				  work location, salary or wage scale, seniority or length of service, or other
				  conditions pertaining to employment.
"Complete claims service office" means an office which
				  receives and processes temporary disability insurance claims and issues such
				  benefit payments.
"Contributions" shall be as defined in section
				  392-3,
				  HRS.
"Current employment" includes the period any employee is
				  receiving workers' compensation benefits for temporary total disability,
				  vacation or sick leave pay, or temporary disability insurance benefits.
"Department" means the department of labor and industrial
				  relations.
"Director" shall be as defined in section
				  392-3,
				  HRS.
"Disability" shall be as defined in section
				  392-3,
				  HRS.
"Disability during employment" means the total inability of
				  an employee, as a result of injury or sickness not arising out of and in the
				  course of the individual's employment, to perform the regular duties of the
				  individual's employment or the duties of any other employment which the
				  employer may offer the individual at the individual's regular wages.
"Disability during unemployment" means the inability of a
				  claimant to qualify for benefits under chapters
				  383 and
				  384, HRS, as a result of injury or
				  sickness not arising out of and in the course of an employment.
"Domestic service in a private home" means service in or
				  about the home of the individual's employer.
"Employee" means any individual who performs services in
				  employment for an employer.
"Employer" shall be as defined in section
				  392-3,
				  HRS.
"Employment" as defined in section
				  392-3, HRS,
				  includes services performed by an individual for wages or under any contract of
				  hire irrespective of whether the common-law relationship of master and servant
				  exists unless and until it is shown to the satisfaction of the director
				  that:
(1) The individual has been and will continue to be free from
				  control or direction over the performance of the service, both under the
				  individual's contract of hire and in fact; and
(2) The service is either outside the usual course of the
				  business for which the service is performed or that the service is performed
				  outside of all the places of business of the enterprise for which the service
				  is performed; and
(3) The individual is customarily engaged in an independently
				  established trade, occupation, profession, or business of the same nature as
				  that involved in the contract of service.
"Injury or sickness" means accidental injury, disease,
				  infection, or illness. Sickness includes the total inability of an employee to
				  perform the duties of her or usual employment because of pregnancy or the
				  normal incidents of pregnancy or the termination thereof.
"Insurer" as used in section
				  392-42.5,
				  HRS, means any insurance company authorized by the insurance commissioner to
				  underwrite, sell, or transact temporary disability insurance in the State of
				  Hawaii and any employer or association of employers who has been granted
				  self-insured status under section
				  392-41,
				  HRS, beginning January 1, 1992.
A "plan" includes any definitive insured or properly
				  self-insured program, effectively providing for employees cash disability
				  benefits that differ from the benefits required to be provided under the
				  statute, either as to rate, waiting period, maximum or minimum benefits,
				  duration of benefit period, or in any other respect. A plan may provide
				  benefits for all of the employees of an employer, or for some class or classes
				  of the employees of an employer.
"Purchase of insurance" means the acceptance as of a specific
				  date of approval of an employer's temporary disability insurance application by
				  an insurance company licensed to sell temporary disability insurance in
				  Hawaii.
"Regular wages" means the wages that the employee would have
				  earned if the disability had not prevented the employee from working.
"Statute" means chapter
				  392, HRS, entitled temporary
				  disability insurance law.
"Wages" shall be as defined in section
				  392-3,
				  HRS.
"Week" means a period of seven consecutive days.
"Weekly benefit amount" shall be as defined in section
				  392-3,
				  HRS.