Voluntary Special Enrollment Period for Off-Marketplace Health Plans
March 02, 2021
On February 26, 2021, Commissioner Hayashida issued Memorandum 2021-1H, encouraging insurers to offer a special enrollment period (SEP) to permit individuals to enroll in ACA-compliant off-marketplace health plans. This SEP is encouraged as the federal marketplace will reopen for a 90-day SEP pursuant to President Biden’s executive order.
Insurers that choose to provide this parallel SEP to plans outside the marketplace should submit an informational filing with a letter and documents as required by the commissioner.
This information may be of use to employees who have not been able to enroll in other coverage. However, this SEP for non-exchange coverage would likely not give rise to a qualifying event that would allow employees to terminate their employer group health plan coverage. It is also important to note that these private health plans often meet ACA requirements, but consumers would not qualify for premium tax credits to help pay for them.
Employers with employees in Hawaii should be aware of this development.
Memorandum 2021-1H »
Voting Leave Repealed
August 20, 2019
On June 28, 2019, Governor Ige signed HB 1248 into law. Effective with the 2020 primary election, the law requires all elections statewide to be conducted by mail. Because of this requirement, an employee's absence during the day will not be necessary in order to visit a polling location. Thus, the new law also repeals the voting leave law, which provided employees with up to two hours of leave for the purpose of voting.
HB 1248 »
Revised Disability Compensation Notice
February 05, 2019
The Department of Labor and Industrial Relations has issued a revised version of the “Disability Compensation Law Notice to Employees,” which must be posted in the workplace. The poster advises employees of their right to temporary disability insurance, prepaid health care and workers compensation benefits.
Revised Disability Compensation Law Notice to Employees »
August 21, 2018
On July 11, 2018, Gov. Ige signed HB 2145 into law. The new law allows for medication synchronization for participants who are taking two or medications for chronic conditions. The synchronization allows for the multiple medications to be filled at the same time by the same network pharmacy, which the new law states increases medication adherence. The new law specifically requires group health insurance policies to provide coverage for partial supplies of such medication (less than a 30 day supply) with prorated cost sharing applied. The law was effective July 1, 2018.
HB 2145 »
Restrictions on Short-Term, Limited-Duration Policies
August 21, 2018
On July 10, 2018, Gov. Ige signed HB 1520 into law. The new law prohibits an insurer from issuing or renewing a short-term, limited-duration health insurance policy for an individual who was eligible to purchase individual health insurance through the marketplace during open enrollment or a special enrollment period in the previous calendar year. Further, insurers are prohibited from issuing such a policy with a coverage period longer than 90 days. This law is more restrictive than the recently issued federal regulations related to short-term, limited-duration health insurance policies, which permits renewals for up to 36 months.
HB 1520 »
Transitional Policies Extended
August 07, 2018
Insurance Commissioner Ito announced in Memorandum 2018-2H that insurers will be allowed to renew noncompliant individual and small group non-grandfathered plans with policy years beginning on or before Oct. 1, 2019. This is related to the CMS announcement on April 9, 2018 of an extension to the transitional policy for non-PPACA-compliant health benefit plans. Such plans must have existed before Oct. 1, 2013 and aren’t required to be in compliance with certain PPACA mandates, including community rating, coverage of essential health benefits, prohibition on pre-existing condition exclusions and the annual out-of-pocket maximum limit. Employers with non-PPACA-compliant plans should work with their carrier and advisor in determining whether their plan can be extended.
Memorandum 2018-2H »
Adoption of ACA Mandates
July 24, 2018
On July 5, 2018, Gov. Ige signed SB 2340 into law. The new law amends Hawaii’s Revised Statutes to impose the following requirements on group health insurance policies issued in the state:
- Provide coverage to children until age 26 (if the policy already provides coverage for children)
- Prohibition on pre-existing health conditions exclusions
- Prohibition on using a participant’s gender to determine premiums or contributions
This doesn’t currently impact group health insurance policies, as they’re already required to be in compliance with these provisions under the ACA. The purpose of this new law is to protect these provisions in case they’re repealed at the federal level. If that were to happen, policies issued in Hawaii would still be required to be in compliance with these three requirements.
The law was effective upon the governor’s signature.
S.B. 2340 »
Family Leave Expansion
September 19, 2017
On July 10, 2017, Gov. Ige signed HB 213 into law. The new law expands the state’s existing family leave law. As background, employers who have 100 or more employees working in Hawaii must provide up to four weeks of unpaid leave in a 12-month period to eligible employees. Employees are eligible if they have worked for the employer for at least six months and have a qualifying reason.
Qualifying reasons include birth, adoption and to care for a family member (employee’s child, spouse, reciprocal beneficiary or parent) with a serious health condition. The new law adds a sibling to the list of family members for whom the employee may take leave. Additionally, the death of the employee’s child, spouse, reciprocal beneficiary, parent or spouse has been added as the fourth qualifying reason for leave.
The employer may require certification, such as a statement from a health care provider when leave is to care for a seriously ill family member or a death certificate following the death of a family member. The law was effective July 10, 2017.
HB 213 »
Network Access and Adequacy
August 08, 2017
On July 12, 2017, Gov. Ige signed SB 387 into law. The new law requires insurers that offer network plans to maintain a network that is sufficient in numbers and appropriate in types of providers, including those that serve predominantly low-income, medically underserved individuals. This is to ensure that all covered benefits will be accessible without unreasonable travel or delay. Covered participants must have access to emergency services 24 hours per day, seven days per week.
If the network doesn’t include a type of participating provider or has an insufficient number or type of providers to provide a specific covered benefit to a participant without unreasonable travel or delay, the benefit must be paid at in-network levels.
Insurers must electronically post a current and accurate provider directory, which must be updated at least monthly. The general public must be able to view the directory without creating or accessing an account or entering a policy number.
The law is generally effective for policy years beginning on or after Jan. 1, 2019.
SB 387 »
Transitional Policies Extended
April 18, 2017
On March 1, 2017, Hawaii Insurance Commissioner Ito announced in Memorandum 2017-3H that insurers will be allowed to renew noncompliant individual and small group non-grandfathered plans with policy years beginning on or before Oct. 1, 2018. This is related to the Feb. 23, 2017, CMS announcement of an extension to the transitional policy for non-PPACA-compliant health benefit plans. Such plans must have existed before Oct. 1, 2013 and are not required to be in compliance with certain PPACA mandates including community rating, coverage of essential health benefits, prohibition on pre-existing condition exclusions and the annual out-of-pocket maximum limit. Employers with non-PPACA-compliant plans should work with their carrier in determining whether their plan can be extended.
Memorandum 2017-3H »