• Hawaii requires all employers to provide health insurance coverage to employees who meet certain requirements. You are not required to accept coverage offered by your employer. For example, you may prefer to accept coverage offered by your spouse’s employer.
• You must work for your employer at least 20 hours per week for 4 consecutive weeks. If you have more than one job, the employer for whom you work at least 20 hours per week will provide health coverage. If you work more than 20 hours per week for more than one employer, you can choose which employer health plan to join. However, if one of your employers is a government entity and you elect coverage, you must elect the government employer plan.
• Employers are not required to provide health benefits to seasonal workers.
• Employer sponsored health coverage must be through an approved “prepaid group health care plan.” A prepaid group health care plan must cover benefits required by state law, including at least 120 days of hospital care per year, physician services, diagnostic lab tests and x-rays, substance abuse treatment and maternity care (if enrolled in the plan at least 9 months before delivery).
• Your employer must pay at least one-half of your health plan premium. If your group coverage is under one of the “prevalent” group health plans (those sold by Kaiser or Hawaii Medical Services Association - also know as HMSA), your employer is not required to contribute to the cost of dependent coverage. However, if your group coverage is under a plan other than one of the prevalent plans, your employer is required to pay half of the premium for you and your dependents.
• In Hawaii, an employer who is otherwise exempt from offering an employee coverage, because that employee has other coverage through another employer, spouse or government program, is required to offer coverage to that employee if the employee loses their other coverage.
• Under Hawaii law, newborns, adopted children, and children placed for adoption are automatically covered under the parents’ fully insured health plan for the first 31 days, if the plan covers dependents. The insurer may require that the parent enroll the child within the 31 days in order to continue coverage beyond the 31 days.
• In Hawaii, adult dependents who are physically disabled or mentally retarded are able to stay on their parents’ fully insured group health plan after they have reached the age at which the health plan usually cancels dependent coverage. In order to be eligible, the adult dependent must be incapable of self-support and must be dependent on the policyholder for support. Proof of incapacity must be provided to the health plan within 31 days of reaching the limiting age.
• If you have to take leave from your job due to illness, the birth or adoption of a child, or to care for a seriously ill family member, you may be able to keep your group health coverage for a limited time. A federal law known as the Family and Medical Leave Act (FMLA) guarantees you up to 12 weeks of job-protected leave in these circumstances.

The FMLA applies to you if you work at a company with 50 or more employees.

If you qualify for leave under FMLA, your employer must continue your health benefits.  You will have to continue paying your share of the premium.

If you decide not to return to work at the end of the leave period, your employer may require you to pay back the employer’s share of the health insurance premium. However, if you don’t return to work because of factors outside your control (such as a need to continue caring for a sick family member, or because your spouse is transferred to a job in a distant city), you will not have to repay the premium.

For more information about your rights under the FMLA, contact the U.S. Department of Labor.