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Employee Health Benefits in Hawaii

Hawaii generally requires employers to provide Prepaid Health Care coverage to eligible employees, including workers who work at least 20 hours each week for four consecutive weeks and meet the wage test. Before buying a nationwide plan or choosing self-funding, confirm Department of Labor and Industrial Relations approval and the employee’s eligibility or annual waiver. 1,2

What Is Employee Health And Benefits?

Employer health benefits give eligible staff access to medical care through a group plan or another employer arrangement. When setting a budget or renewing, compare eligibility, provider networks, employee contributions and total cost. Read the national Employee health and benefits guide.

Hawaii Requirements

RequirementDetails
Prepaid Health Care eligibilityAt least 20 hours weekly for four consecutive weeks and monthly wages of at least 86.67 × the current Hawaii minimum hourly wage; statutory exclusions apply. 1
Employer contribution for employee-only coverageEmployer pays at least 50% of premium; employee share is capped at the lesser of 50% of premium or 1.5% of gross wages. 1

What to Watch for in Hawaii

  • Count Hours and Exceptions Employee by Employee

    Hawaii DLIR describes an eligible employee as working at least 20 hours each week for four consecutive weeks and earning at least 86.67 times the current state minimum hourly wage per month; listed exclusions include seasonal agricultural workers, public employees, certain family employees and workers below 20 hours. An approved exemption must be documented on Form HC-5 each calendar year. Track hours and wages and calendar the renewal instead of relying on a full-time label. 1

  • Get the Hawaii Plan Approved

    DLIR says plans must meet its minimum standards and be approved. It offers approved contractor coverage, an employer’s insured plan subject to review, and self-insurance subject to financial-solvency review and annual audited statements; ask who will file the plan and maintain approval. 2

  • Model the Employee Premium Cap

    For employee-only coverage, DLIR says the employer pays at least half and cannot deduct from the employee more than 1.5% of gross wages; if that cap is below half the premium, the employer pays the remainder. Price the employer share using actual payroll and plan rates, not a flat national contribution assumption. 1

  • Confirm the One-Year Plan Election

    HRS §393-12 requires the employer to choose whether its contractor furnishes care or reimburses expenses, and that plan-type election binds the employer for one year. The employer may choose a contractor, but an employee’s contribution cannot exceed the amount under the prevailing contractor for that plan type; compare the funding/service model and payroll deductions before the election. 3

Who Regulates Insurance in Hawaii

Hawaiʻi Insurance Division

The Insurance Division oversees insurance companies and producers, examines Hawaiʻi-based insurers, reviews rate and policy filings, and investigates insurance complaints. It is part of the Department of Commerce and Consumer Affairs. 4,5,6

Surplus-lines tax and stamping office

Reported tax rate: 4.68% of premium when Hawaiʻi is the home state Hawaiʻi applies a 4.68% tax when it is the insured’s home state. Surplus-lines coverage is placed with an unauthorized insurer, so do not assume the Hawaiʻi Insurance Guaranty Association protects the policy; confirm the insurer’s status and policy terms with your broker. 7,8

Providers With Documented State Licenses

No provider in Spot’s research documents both a state license record and this coverage line. This does not establish that providers are unlicensed. Check the regulator’s license lookup and confirm availability with a provider when requesting a quote.

Questions to Ask Before You Buy in Hawaii

  1. “Which of our Hawaii workers meet the weekly-hours, four-week and wage tests, and which exclusions are documented?”
  2. “Has DLIR approved this exact plan and plan type for Hawaii, including our nationwide or self-funded option?”
  3. “What payroll-based employee contribution cap and dependent-cost treatment apply to each quoted plan?”

Employee Health And Benefits in Hawaii: FAQ

When does a Hawaii employee qualify for Prepaid Health Care coverage? 1

Generally, after working at least 20 hours a week for four consecutive weeks and meeting the wage test; DLIR also lists statutory exclusions, including seasonal agricultural employment and some family employment. 1

Can a Hawaii employer self-fund its employee health plan? 2

Yes, but DLIR requires prior plan approval and proof of solvency and ability to pay benefits, with annual audited financial statements for continued approval. 2

Employee Health And Benefits in Other States

Other Coverage in Hawaii

Sources

  1. Frequently Asked Questions About Prepaid Health Care. Hawaii Department of Labor and Industrial Relations, Disability Compensation Division; Employee FAQ “Who is eligible?” (formula: 86.67 × current Hawaii minimum hourly wage per month), “How much can my employer charge?”, employer scope/exclusions, coverage methods, and annual HC-5 exemption; current page accessed 2026-09-28. Accessed 2026-09-28.
  2. About Prepaid Health Care. Hawaii Department of Labor and Industrial Relations, Disability Compensation Division; Employer’s three coverage methods, plan approval, self-insurance solvency and annual audited statements; current page accessed 2026-09-28. Accessed 2026-09-28.
  3. Hawaii Revised Statutes §393-12 — Choice of Plan Type and Contractor. Hawaii State Legislature; §393-12(a)–(b), binding one-year election and contribution cap relative to prevailing coverage; current code accessed 2026-09-28. Accessed 2026-09-28.
  4. Insurance Division. Hawaiʻi Department of Commerce and Consumer Affairs; Official division homepage; scope, license search, complaints, contact information. Accessed 2026-09-28.
  5. Insurance Licenses and Registrations. Hawaiʻi Insurance Division; Insurance license information; links to state-based system for license applications and status. Accessed 2026-09-28.
  6. Filing a Complaint. Hawaiʻi Insurance Division; Online complaint form and published consumer phone. Accessed 2026-09-28.
  7. Surplus Lines Tax. Hawaiʻi Insurance Division; 4.68% rate and home-state application under HRS § 431:8-315. Accessed 2026-09-28.
  8. HRS § 431:16-105: Definitions. Hawaiʻi Legislature; Defines a member insurer as an insurer licensed or holding a certificate of authority in Hawaiʻi; cross-read with HRS § 431:8-102 and § 431:8-301 for unauthorized surplus-lines placements. Accessed 2026-09-28.
  9. Licenses. At-Bay; Current producer introduction and state table; At-Bay Insurance Services LLC; P&C and surplus-lines identifiers. Accessed 2026-09-21.
  10. Licenses and Carriers. Coalition; Licenses and Carriers, re-read 22 September 2026: Insurance Licenses table for Coalition Insurance Solutions, Inc., national producer number 18419475, with producer and surplus-lines numbers for all 50 states and DC including California 0L76155, Georgia 196479, Texas 2199630 and 2205589, Pennsylvania 815731 and 817452, Colorado 539028 and Wisconsin 3000108852. Insurance Carriers table naming, with NAIC numbers, Allianz Underwriters Insurance Company 36420, Arch Specialty Insurance Company 21199, Ascot Specialty Insurance Company 45055, Ascot Insurance Company 23752, Aspen Specialty Insurance Company 10717, Chaucer Insurance Company DAC, Coalition Insurance Company 29530, Fireman's Fund Indemnity Corporation 11380, Fortegra Specialty Insurance Company 16823, Lloyd's of London, MSIG Specialty Insurance USA Inc. 34886, MS Transverse Specialty Insurance Company 41807, Steadfast Insurance Company 26387, Vantage Risk Specialty Insurance Company 16275 and Zurich American Insurance Company 16535. Accessed 2026-09-22.
  11. Insurance Producer Licenses. Corgi Insurance; Current complete Insurance Producer Licenses table for Corgi Insurance Services, Inc.; 50 rows covering 49 states and DC (DC 3003091619); no New Mexico row; no NPN or as-of date shown. Accessed 2026-09-28.
  12. About Hiscox US Insurance. Hiscox; Hiscox Insurance Company Inc. NAIC 10200 as Chicago, IL domiciled insurer admitted or licensed in all 50 states and D.C.; Hiscox Inc. as general agent and Lloyd’s coverholder for Syndicates 33 and 3624; surplus-lines placements through licensed surplus-lines brokers; A.M. Best rating statement. Accessed 2026-09-16.
  13. Licenses. ERGO NEXT Insurance; Current entity-by-state license table reopened 28 September 2026: 50 rows under Next First Insurance Agency, Inc., including Washington, DC; New York rows instead list Next Insurance Services PC-1423070 and AP Intego BR-1198885. Accessed 2026-09-28.
  14. Insurance Licenses by State. TechInsurance; Current state table; identifies TechInsurance as a division of Specialty Program Group LLC d/b/a SPG Insurance Solutions; lists DC 3000041536 and labels Rhode Island “Individual licenses,” without an agency license number. Accessed 2026-09-28.
  15. Licenses. Vouch; Effective 16 January 2025: Vouch Specialty Insurance Services, LLC, NPN 19926463; P&C table (50 states and DC); surplus-lines table includes Idaho 870820; footnote says Georgia and Idaho do not issue agency-level surplus-lines licenses; Idaho retained as producer-only due to conflict. Accessed 2026-09-15.

Updated .

This guide is informational and does not determine whether a policy is available or meets your needs. Editorial policy. To suggest a correction, contact Spot with a supporting source.

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