Hawaii Administrative Code

If any benefits due an employee are unpaid at the time of the employee's death, the benefits shall be payable to the employee's estate or, at the option of the carrier, may be paid to the surviving spouse, parent, child, or children of the deceased employee. Benefits that are due…

Pursuant to section 392-26(a) and (b), HRS, an authorized physician, surgeon, dentist, chiropractor, osteopath, or naturopath includes any person duly licensed to practice medicine, surgery, dentistry, chiropractic, osteopathy, or naturopathy in this State; or a duly authorized o…

(a) Except as otherwise provided herein or when shown to be inappropriate or unfeasible, for the purpose of computing the amount of disability benefits of a non-salaried employee during any period of disability, "average weekly wage" shall be the amount determined by dividing the…

(a) Board, lodging, or any other payment in kind received by an employee from the individual's employer in addition to or in lieu of (rather than as a deduction from) money wages shall be deemed to be wages paid by the individual's employer. (b) The reasonable cash value of such …

In the event a claimant is disabled at the end of a calendar year and the claimant's disability continues into the next calendar year, the claimant's disability payment shall be calculated on the basis of the established rate at the time the claimant's disability commenced. Notes…

Should an employer fail to provide coverage after deducting and withholding contributions from the individual employees, the employer shall deposit such contributions not to exceed 0.5 per cent of the employees' weekly wages, as determined pursuant to section 392-43, HRS, into th…

The director or the director's authorized representative may administer oaths, take or cause to be taken the depositions of witnesses, and require the attendance and production of all books, records, and other evidence relative to any matter under investigation or audit. The subp…

Pursuant to section 392-43(f), HRS, contributions of those employees, deducted and withheld in amounts greater than those authorized, who are no longer with the employer and cannot be located, shall be deposited at the end of each calendar year in the special fund for disability …

Notes Haw. Code R. §§ 12-11-51 to 12-11-55

Each employer shall post and maintain in a conspicuous place or places in and about the employer's places of business typewritten or printed notices stating that the employer has obtained insurance to provide for the payment of disability benefits required by law, in the form as …

(a) Every contract of insurance, including any amendment, endorsement, or rider to a contract of insurance, which provides for employee benefits under the statute shall be approved by the insurance commissioner. (b) Nothing in the statute or in this chapter is intended to amend, …

(a) No insurer shall cancel a contract of insurance providing in whole or in part for disability benefits required by the statute prior to the expiration date of the contract unless notice of intention to cancel on a specified date has been filed with and served on the employer a…

(a) If an employer provides for disability benefits under the statute by a contract of insurance, the premium charged therefor shall represent the cost of providing the benefits. The employees' contributions shall not exceed one-half of the cost but not more than 0.5 per cent of …

Notes Haw. Code R. §§ 12-11-6 to 12-11-10

If an insurance company refuses to cover any employer-applicant, the insurance company shall notify the employer-applicant in writing of the name and address of the pool manager of the Hawaii temporary disability insurance risk spreading plan. A copy of the letter shall be kept i…

Notes Haw. Code R. §§ 12-11-61 to 12-11-65

Each employer who has been granted self-insured status pursuant to the statute and this chapter shall post and maintain in a conspicuous place or places in and about the employer's places of business typewritten or printed notices stating that the employer is providing directly f…

(a) Every employer and every association of employers, or trustee or trustees paying benefits under a plan or agreement authorized under section 392-41, HRS, desiring to provide for the payment of benefits through approved self-insurance, shall apply to the director to become a s…

Each applicant for self-insurance shall execute and file with the director an agreement, on a form prescribed by the director,: (1) To pay benefits to employees eligible under the law: (A) As provided in the statute, if there is no plan applicable to the employees; (B) As provide…

An applicant for self-insurance shall: (1) Deposit with the State director of finance, and keep on deposit, securities which are obligations of the United States, or any other state, Hawaii or any of its counties, provided that the securities were issued pursuant to law and the f…

The amount of securities or of the penal sum of the surety bond which a self-insurer is required to deposit pursuant to section 12-11-69 shall be determined by the director. The number of employees involved, the exposure, the financial standing of the applicant, and other factors…

Each applicant shall submit proof satisfactory to the director that adequate provision has been made by the applicant, and by each employer, to comply with the obligation to pay benefits, and from time to time, upon request, shall satisfy the director that the provision is kept e…

(a) A self-insurer who has terminated self-insured status, or as to whom approval for self-insurance has been revoked, may apply to the director for return of the security deposit or cancellation of the surety bond. (b) After the lapse of twenty-four months from termination of se…

If an employer has deposited securities under the workers' compensation law, the director in his discretion may reduce the amount of deposit required under the statute provided the employer has, by agreement satisfactory to the director, made available all deposited securities fo…

The obligations of a self-insurer shall include all obligations and those of each and every employer with respect to those employees for whom the self-insurer provides benefits under the statute. Notes Haw. Code R. § 12-11-74 [Eff 5/11/81] (Auth: HRS § 392-91) (Imp: HRS § 392-41)…

The director may revoke the approval to self-insure at any time for good cause. Failure to comply with this chapter, or with any award, order, or directive of the director, either by the self-insurer or an employer or employers for whose employees benefits are provided by the sel…

(a) If an employer provides for disability benefits under the statute through self-insurance, the cost of the benefits shall include any expenses of the employer directly allocable to the cost of administering and providing the benefits. The employees' contributions shall not exc…

The separate fund provided by section 12-11-76 shall not exceed five per cent of the employer's highest monthly payroll in the last twelve completed calendar months. No further deductions shall be made from employees until the fund falls below the five 1/2 percent indicated above…

Notes Haw. Code R. §§ 12-11-78 to 12-11-84

(a) On March 1 of each year, the employer's insurance carrier, self-insured employers, employers with collective bargaining agreements, or an association of employers shall file an annual report covering the most recently completed calendar year in a form prescribed by the direct…

Every employer for whom services are performed in employment shall file a report on a form prescribed by the director to determine liability for coverage within ten days after being mailed by the department. This report shall provide information such as: Under an insured plan, th…

As used herein: "Continuation of coverage in case of inability to earn wages" means that allocation of health care premium will be based on an employee's continuing salary, if this be the case, or the salary or wages that the employee received in the last fully completed month pr…

An employer may provide an approved individual or a group plan. Notes Haw. Code R. § 12-12-11 [Eff: 5/7/81] (Auth: HRS § 393-32) (Imp: HRS §§ 393-7, 393-11, 393-12, 393-13, 393-14, 393-15)

An employer may elect to provide more than one approved plan from the same or different health care contractor. The employer shall not be liable for more than the cost of the least expensive plan should there be more than one plan. Notes Haw. Code R. § 12-12-12 [Eff: 5/7/81] (Aut…

An employer may provide different plans for different classes of employees. The employer shall not, however, exceed the withholding requirements of section 393-13, HRS, should classes of employees be provided different plans. Notes Haw. Code R. § 12-12-13 [Eff: 5/7/81] (Auth: HRS…

Any employer-sponsored plan shall be submitted to the department by the authorized health care contractor in accordance with section 12-12-16. Notes Haw. Code R. § 12-12-14 [Eff: 5/7/81] (Auth: HRS § 393-32) (Imp: HRS §§ 393-7, 393-20)

Any prepaid health care plan included in a collective bargaining agreement: (1) Is presumed to meet the requirements of the statute if the agreement is dated prior to June 3, 1978. (2) Shall meet the requirement of the statute if the agreement is dated on or after June 3, 1978. (…

(a) After the approval of a health plan by the Hawaii State Insurance Commissioner or a signed statement that the plan does not require approval, the health care contractor shall submit eight copies of the plan to the department for review. Each plan shall have attached thereto t…

(a) Each employer shall inform an eligible employee of the entitlement afforded by this statute by providing the health care contractor's name, plan number, group number, effective date of coverage, and employee's cost. (b) The employer shall give each covered employee thirty day…

(a) When a health care contractor whose health care plan has been approved pursuant to section 393-7, HRS, subsequently provides supplemental benefits such as vision, drug, and dental coverage, these supplemental benefits shall then become a part of the employer's health care pla…

Notes Haw. Code R. §§ 12-12-19 to 12-12-23

(a) Employers believing themselves to be engaged in seasonal pursuits shall file a request for such determination with the director. The request shall contain data and information necessary to qualify the employer within the provisions as set forth in section 12-12-1 of this chap…

Any self-insurer may qualify as a health care contractor upon furnishing satisfactory proof to the director of its solvency and financial ability to defray or reimburse in whole or in part the expenses of health care under an approved health care plan. Notes Haw. Code R. § 12-12-…

Every health care contractor required to be licensed by the Hawaii State Insurance Commissioner shall be so licensed before submission of plans to the department. Notes Haw. Code R. § 12-12-25 [Eff: 5/7/81] (Auth: HRS § 393-32) (Imp: HRS §§ 393-3, 393-7, 393-12)

(a) Every health care contract of insurers subject to the insurance laws of the State, including any amendment, endorsement, or rider to a contract, which provides for benefits under section 393-7, HRS shall be approved by the Hawaii State Insurance Commissioner prior to submissi…

(a) Every covered employee shall be given written evidence of health care coverage by the employer, which has been provided by the health care contractor. (b) The health care contractor shall permit continuation of coverage without any diminution of benefits or standards from the…

(a) No health care contractor shall cancel a contract providing in whole or in part for health care benefits required by the statute prior to the expiration date of the contract unless written notice of intention to cancel on a specified date and reason therefor has been filed wi…