Hawaii Administrative Rules › Title 24 - HAWAII EMPLOYER-UNION HEALTH BENEFITS TRUST FUND ADMINISTRATIVE RULES › Sec2 5.00 - HEALTH AND OTHER BENEFIT PLANS › Section 24-5.02 - Changes in Enrollment; Effective Dates of Coverage

Current through June, 2024
(a)
Additions of Dependents Due to Changes in Marital. Partnership,
			 Legal Guardianship, or Family Status.
An employee-beneficiary may
			 change his or her enrollment to add coverage for dependent-beneficiaries in the
			 Fund health benefit plans in which the employee-beneficiary is currently
			 enrolled upon the occurrence of any of the following events: marriage, entry
			 into a partnership, birth of a child, adoption of a child, addition of a foster
			 child, or the issuance of a qualified medical support order. At the option of
			 the employee-beneficiary, the effective date of the change in enrollment shall
			 be the date of the event or the first day of the first pay period following the
			 date of the event or the first day of the second pay period following the
			 event, provided an enrollment application is filed with the employer for active
			 employee-beneficiaries and to the Fund for retirees within thirty (30) days of
			 the event, except in the event of a birth of a child in which case the
			 enrollment application shall be filed with the employer or in the case of a
			 retired employee-beneficiary with the Fund within one hundred eighty (180) days
			 of the birth.
(1) With respect to the
			 addition of a spouse or civil union partner, as well as dependent(s) of a new
			 spouse or civil union partner, the date shall be the event date indicated on
			 the marriage or civil union certificate.
(2) With respect to the addition of a
			 domestic partner, as well as the dependent(s) of a domestic partner, the event
			 date shall be the date the notary notarizes the Declaration of Domestic
			 Partnership.
(3) With respect to
			 the birth of a child, the event date shall be the birth date.
(4) With respect to the addition of a foster
			 child, the event date shall be the date indicated on the State of Hawaii
			 Department of Human Services Form 1564, Admission to Foster Home.
(5) With respect to the adoption of a child,
			 the event date shall be the date of the adoption (which may occur up to 1 year
			 after the child was initially placed for adoption). For placement of adoption
			 or legal guardianship, the event date shall be the date of
			 guardianship.
(6) With respect to a
			 qualified medical child support order, the event date shall be the date
			 specified in the order, or if no date is specified, the date that the order is
			 issued.
(7) With respect to a
			 dependent-beneficiary joining the employee-beneficiary's household; the date of
			 the event shall be the date the dependent-beneficiary joined the
			 employee-beneficiary's household if the dependent-beneficiary lived in a
			 residence outside of the geographic areas covered by the employee-beneficiary's
			 present benefit plan, provided a completed enrollment application is submitted
			 within 30 days of the event. Proof documents may be required.
Proof documents for each of the above events may be
				required.