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.

What Is Employee Health 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 Employee Health Benefits Requirements

Requirement	Details
Prepaid Health Care eligibility	At 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 coverage	Employer 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 Should You Watch for With Employee Health Benefits 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

Which Employee Health Benefits Providers Have Hawaii License Records?

No provider in our research has both a state license record and a listing for 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.

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

Website: Regulator website
License lookup: Search licensed producers
Complaints: File a complaint
Phone: 1-844-808-3222

Surplus-Lines Tax and Stamping Office in Hawaii

Reported tax rate. 4.68% of premium when Hawaiʻi is the home state ^7,⁸

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.

What Should You Ask Before Buying Employee Health Benefits in Hawaii?

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