Frequently asked questions

What is COBRA and what are the eligibility requirements for COBRA?

The Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) is a federal law that requires companies (except for certain church plans and certain governmental plans) to offer their employees health care coverage if they employed at least 20 workers (both full- and part-time) during 50 percent of the business days in the preceding calendar year. COBRA requires these employers to permit continued group coverage, at the enrollees’ expense and for clearly specified periods of time, for qualified beneficiaries who would otherwise lose coverage as a result of certain events, such as termination, death of a spouse, divorce, loss of dependency status, and spouse’s entitlement.

Who is responsible for administering COBRA and providing employee notification?

The Plan Administrator (as defined by ERISA) is always the employer or a third-party administrator appointed by the employer. Kaiser Foundation Health Plan, Inc. (KFHP), has not agreed to be the Plan Administrator for any employer. We are, however, the Plan Fiduciary (as defined by ERISA) for claims review for those ERISA Plan beneficiaries enrolled as members.

It is always the employer’s responsibility to notify employees about COBRA. Members who call us for COBRA information will be referred back to their employers. We will honor enrollment based on the minimum time frames as specified in COBRA.

What is TEFRA?

The Tax Equity and Fiscal Responsibility Act of 1982 (TEFRA) amended the Age Discrimination in Employment Act, which affects employers with 20 or more employees. It requires you to offer active employees and their spouses, ages 65 and over, the identical medical coverage as offered to active employees under age 65. TEFRA requirements are detailed and complex. Questions regarding your obligations under the law should be addressed by your legal counsel or benefits expert. You may also obtain information from the federal Equal Employment Opportunity Commission (EEOC).

What group plan benefit options are available?

There are various group plan coverage options for your business. Medical, prescription drug, vision, complementary and alternative medicine, and dental are possible options.

What are the requirements for a group plan?

Your business must have an active Hawaii unemployment insurance identification number (DOL number) from the state of Hawaii Department of Labor.

We reserve the right to ask for any documentation to verify that the business is active and that there are legal employees who must be offered health insurance per the Prepaid Healthcare Act. This requested documentation may include, but is not limited to, submission of the following:

  • UC-B6 Quarterly Wage Filing (identifies quarterly wages paid to each employee)
  • HW-14 Withholding Tax Return (identifies the total monthly or quarterly wages paid and the total income taxes withheld)
  • Federal Income Tax forms

Download our eligibility requirements to find out if your business is eligible for coverage.

How do I get a group plan rate quote?

You can request a rate quote by email, mail or fax. Click here to find out how to apply for coverage. (large business).

How quickly can I receive a rate quote?

Within five working days, provided the Customer Rate Request form and Employee Census Grid are completed accurately.

Who will let me know about my rate quote?

A sales representative will provide you with a rate packet.

I have selected my group plan benefits and accepted the rates. What do I do next?

Please call us at 808-432-5919 (Oahu) or 1-866-381-3044 (Neighbor Islands) to confirm acceptance.

When is my group plan membership effective?

If all the required information is accurate and received by the 15th of the month, membership is effective the first of the following month.

Whom should I call if I have questions?

You may call us at 808-432-5919 (Oahu) or 1-866-381-3044 (Neighbor Islands)

You may also contact a sales representative online.

Forms

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Call Client Services at 808-432-5256 or 1-888-352-4737

Sales representative

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