Frequently Asked Questions

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Transparency in Coverage and No Surprises Act

What is the Transparency in Coverage and No Surprises Act?

Refer to our overview here for details.

Group Administrator Change & Group Administration

I am a new Human Resources (HR) person handling the medical benefits for my company. How do I add myself as an authorized Group Administrator?

To add or remove an authorized Group Administrator, please complete a Group Information Change Form and send it to UHA. Please note that the form must be signed by a company officer or a person who is already an authorized Group Administrator. You cannot add yourself unless you are a company officer. If you are interested in signing up for access to our online portal (for enrollment, bill view and/or bill pay services) please complete an Online Employer Access Authorization and Certification Form.

How do I update my group's billing address, mailing address, phone number, or email address?

Please fill out a Group Information Change Form. The form must be completed and signed by an authorized group administrator. Once complete, please fax to 1-877-222-3198 or email to UHA Employer Services or your Client Services representative for processing.

Eligibility: General

When am I allowed to enroll an employee?

You can enroll employees during any of the following Qualifying Events:

  • When a new employee is hired;
  • Your group’s annual open enrollment period;
  • When an employee becomes eligible for coverage (ex: an employee goes from part time to  full time status); or
  • When an employee loses coverage elsewhere.

Please note that enrollments & terminations must be received within 31 days of the qualifying event. Enrollments are always effective the first of a given month and terminations are always effective on the last day of a given month.

Enrollment forms can be faxed to 1-877-222-3198 or emailed to UHA Employer Services. You can also sign up for the Online Employer Services System and enroll members 24/7 on our safe and secure portal.

Detailed information about eligibility and qualifying events can be found in the Group Administrator Handbook.

How do I add an Eligible Dependent (employee's newborn child, adopted child/children, stepchild/children, newlywed spouse or civil union partner) to the plan?

To enroll an eligible dependent, please complete a Member Enrollment Form. The completed form and the appropriate documents should be submitted to UHA by the Group Administrator. Additions to your health plan must be enrolled within 31 days of births, adoption, marriage, or civil union.

For more information regarding Eligible Dependents, please refer to your Group Administrator Handbook.

Are there deadlines for submitting changes to the group?

Changes to the group’s benefits can be made each year during open enrollment. UHA will send a letter 60 days prior to your renewal date and changes are due at least 30 days prior to your group’s renewal date. Please refer to the Group Administrator Handbook.

How do I terminate coverage for an employee or their dependent(s)?

A member’s coverage can be terminated by using the Member Termination form. Employee eligibility under most medical benefits programs terminates on the last day of the month in which employment ends. Mid-month terminations or retroactive terminations will not be accepted.

I terminated an employee's coverage but now I need to reverse the cancellation. What do I do?

If you terminated an employee’s coverage by accident, or circumstances have changed and they should not be terminated, you can re-enroll them with no break in coverage if the termination date has not yet passed. The quickest way is to re-enroll them is through UHA’s Online Employer Services System or by sending in a completed Enrollment Form. If the termination date has already passed, please contact us at (808) 532- 4000, extension 299.

I enrolled an employee for next month but it turns out he/she will not be eligible. What do I do?

Please complete the Member Termination Form stating the termination date as the day before coverage is going to be effective and send an email to UHA Employer Services or via fax to 1-877-222- 3198 with an explanation.

Until what age does UHA cover dependent children?

UHA will cover all eligible dependent children up until their 26th birthday. If an employee’s dependent is certified as disabled, the dependent may continue coverage after UHA has reviewed and approved enrollment of a completed Disability Certification Form.

My employee is Medicare eligible and will be going onto a Medicare plan and terminating UHA coverage, but his/her or civil union partner spouse is not Medicare eligible yet. Can the spouse keep UHA coverage?

Unfortunately, if the employee is not enrolled with UHA, dependents cannot keep UHA coverage.

My employee (or their dependent) has become Medicare eligible. Is there anything we need to do?

If any of your members become eligible for Medicare, please have them visit the Medicare website for information. Generally, signing up for Medicare can help the member reduce their out-of-pocket costs for medical services, especially when travelling outside the state of Hawaii.

How does UHA handle COBRA enrollment and billing? Does UHA bill the COBRA member directly?

Please refer to our special COBRA Information section.

Our company offers or will be offering both UHA 3000 and UHA 600, and our open enrollment period is coming up. How does an employee switch plans?

If an employee wants to switch between plans at the time of open enrollment, you can submit the Member Change Form or make the change via the Online Employer Services System. If you are sending a PDF form please send it to UHA Employer Services or via fax to 1-877-222-3198. If you would like to conduct open enrollment sessions please make sure to contact your Client Services representative and we will be happy to assist. 

Eligibility: Member ID Cards

How long does it take to get a Member ID card?

Member ID cards are usually mailed within 5 business days after an enrollment or request for a card has been received.

How can an employee or their dependent(s) get a replacement Member ID card?

Your employee can:

  • contact Customer Services
  • or email UHA via our online form
  • or complete and fax a Member Identification Card Request Form

If they register for Online Member Services, they can print out a temporary ID card.

Will dependents receive Member ID cards?

Each subscriber (employee) is issued two UHA Member ID Cards. The cards list the name of the subscriber and each dependent’s name. Please see previous question, “How can an employee or their dependent(s) get a replacement Member ID card?” for information on how to order additional UHA Member ID cards.

Billing

I did not receive my billing statement. Why?

It could be either of the following reasons:

  • If your business moved recently, we may still have your old address in our system. Please contact your dedicated Client Services representative to update your mailing and physical address with UHA any time you have a demographic change. Group Information Change form
  • If you are registered for Online View Bill access, paper billing statements are not sent.

Why am I still getting billed for an employee I removed from coverage last month?

Because of the state’s Prepaid Health Care law, UHA bills for premiums in advance. For example, the January bill is generated and sent in December. Any changes you make after the bill is generated will not show up until your next bill. For example, if an employee leaves on December 15th and you terminate his coverage, he will still appear on your January bill because the bill was already generated. The credit will appear on your February bill that you receive in January. For further assistance, please contact UHA’s Billing Department at (808) 532-4000, extension 353.

What is the best way to send my premium payment to UHA?

There are several ways you can send your payment to us besides mailing it:

How can I find out if my payment was received?

You can check your group’s account status using UHA’s Online Employer Services System. The account balance is updated every 48 hours. You can also contact a billing representative at 808-532-4000 extension 353 to confirm whether your payment was received. Please have your group number, payment amount and check number ready. If you made a direct deposit for your payment, please have your receipt handy for reference.

Rates and Contract Administration

Some of my employees want drug, vision and/or dental coverage, but others just need medical. Is it possible to have more than one benefit option?

It is important that you are aware of the requirements of the Hawaii State Department of Labor. As of January 2014, Health Care Reform requires some employers to provide certain minimum benefits to all eligible employees. Please contact your Client Services representative or broker for more guidance.

Since the Hawaii state law only requires employers to contribute to the single medical premium, can I pass on the cost of the drug, vision and/or dental premiums to my employees?

We suggest contacting the Hawaii State Department of Labor for official clarification.

The Hawaii State Department of Labor said I need to have an HC-15 submitted to prove that we are in compliance. What do I do?

UHA submits a monthly report to the DOL for all new groups, reinstating groups, and terminated groups. If you have been asked to have an HC-15 submitted, you can contact your Client Services representative to check to ensure that your group was reported or to find out when your group will be reported to the DOL to verify your company’s active contract for medical insurance.

How do I request a Schedule A/Form 5500?

Contact your Client Services representative to request the document. Please be specific about the data period you are requesting and who UHA should send it to. A new request must be sent each year. Schedule A/Form 5500s will be made available at the earliest 120 days after the last day of the requested data period.

Does signing the Schedule of Benefits lock me into a 12-month contract? Do I have to wait until my renewal to terminate coverage?

Signing the Schedule of Benefits secures your rates and premiums for 12 months or the stated period of time. You may still terminate your contract before the 12 months are up, but there are some limitations and requirements. Please refer to Article 7 of your Standard Agreement for Group Health Plan for more details.

Online Employer Services

How do I sign up for online access? Are there limitations?

To sign up, please complete and submit an Online Agreement Authorization and Certification Form. The only limitation is that only one authorized user can have Full Access because “Full Access” includes Online Bill Pay.

How soon will I see the Enrollments, Terminations or Changes I made in Online Enrollment?

Online Enrollment takes two business days to reflect on the Online Enrollment site. For example:

  • Tuesday – Enrollment Request entered in Online Enrollment
  • Wednesday – Enrollment Request is submitted to UHA
  • Thursday – The Member will appear in your Online Enrollment account. (The site takes 24 hours to refresh)

I'm having difficulties logging into Online Enrollment/Online Billing. Who do I contact for assistance?

For assistance with logging into your Employer Portal, please call an Enrollment representative at (808) 532-4000, ext. 299.

Brokers

What do I need to get a quote?

In order to receive a quote, please submit a completed Employer Application & Certification Form along with a completed Census Form. The Census Form can also be submitted as an Excel file.

Requests can be sent to Client Services or via fax to 1-877-222-3198.

COVID-19 Vaccine For Employers

Q1. When can my employees receive their COVID-19 vaccines?

Priority for vaccines has been determined by the Centers for Disease Control and Prevention and the Hawaii State Department of Health (HDOH). View the Executive Summary of the Vaccination Plan here.

Recommendations from the Hawaii COVID‐19 Vaccine Allocation and Prioritization Working Group in conjunction with HDOH subject matter experts were used to identify the population groups below. Strong consideration was given to CDC Guidance and adherence to ACIP recommendations (See Figure ES‐6: Vaccine Prioritization Phases).

Source: Hawaii COVID-19 Executive Summary of the Vaccination Plan

For the most detailed and up-to-date information, please see hawaiicovid19.com.

Q2. How can my employees get the vaccine?

Those who meet the criteria for each phase will be able to get the vaccine through any approved COVID-19 vaccine provider, as supplies allow.

Q3. I have an employee who is a kupuna and qualifies for the COVID-19 vaccine but they are uncomfortable with the online registration system. How else can they make an appointment?

The HDOH has a new service for kupuna that simplifies the COVID-19 vaccination registration process. View the HDOH news release here.

  • Seniors or family caregivers can call 2-1-1 to reach Aloha United Way’s team of trained specialists. This service is available seven days a week for those age 65 and older. Call 2-1-1 for personalized assistance in navigating the registration process and securing appointments. The team can also help eligible individuals arrange for transportation to a vaccination provider.
  • Aloha United Way’s 2-1-1 team is responsible for the initial intake process. Information is then securely electronically transferred to the St. Francis Healthcare System call center team. St. Francis will follow up with kupuna who have called AUW’s 2-1-1 within 24 to 48 hours.

Q4. May I require my employees to take the vaccine?

For more information, please contact your own legal counsel.

Q5. Will there be a co-pay?

No. There is no co-pay to receive the COVID-19 vaccine, even from an out-of-network provider. As with the flu shot, this critical vaccine will be provided at $0 co-pay.

Q6. Could UHA set-up COVID-19 vaccine clinics at my organization like is often done with flu shots?

As of this time, we do not anticipate setting up vaccine clinics in our members’ place of business because of a number of unprecedented challenges, including requirements for storage and temperature monitoring equipment, as well as other issues.

Q7. I have concerns about the safety of the COVID-19 vaccine. How can I know that it is safe?

The FDA has approved the COVID-19 vaccines. For more information, please see cdc.gov.

Q8. Where can I learn more about COVID-19 and vaccine developments?

For the most comprehensive and up-to-date information, please see the Centers for Disease Control and Prevention at cdc.gov.

Q9. Where can I learn more about Hawaii’s vaccination plans?

Please see the HDOH at hawaiicovid19.com/vaccine.

An executive summary of the State of Hawai‘i’s draft COVID-19 vaccination plan is available here or view the full draft plan here.

COVID-19 Testing: Stay up to date with the latest CDC guidelines

Q1. What if my employees have been in close contact with a COVID-19 infected co-worker?

If your employee has been in close contact with someone with suspected or confirmed COVID-19, whether they are fully vaccinated or not, they should first be evaluated by their healthcare provider and be tested for COVID-19 if indicated to do so.

Q2. Does UHA cover COVID-19 testing of those who are asymptomatic?

UHA will cover COVID-19 diagnostic testing when the test is, at the time of service, in accordance with updated CDC guidelines. Coverage is subject to change contingent upon evolving CDC guidelines.  UHA will not cover non-diagnostic testing.

Q3. Under what circumstances should my employees obtain a COVID-19 test?

The CDC recommends the following individuals should obtain COVID-19 diagnostic testing:

  1. People who have symptoms of COVID-19 who are fully vaccinated with the COVID-19 vaccine should first be evaluated by their healthcare provider and be tested for COVID-19 if indicated to do so.
  2. People without symptoms of COVID-19 who are not fully vaccinated with the COVID-19 vaccine:
    • who have been in close contact with someone with suspected or confirmed COVID-19, should first be evaluated by their healthcare provider and be tested for COVID-19 if indicated to do so.
    • who have taken part in activities that put them at higher risk for COVID-19, such as travel, attending large social or mass gatherings, or being in crowded indoor settings.
    • who have been asked or referred to get tested by their school, workplace, healthcare provider, state, tribal, local, or territorial health department.

Please review the remaining questions and answers as to whether UHA will provide coverage for a COVID-19 test in specific situations.

Q4. Does UHA cover employer requested COVID-19 testing or testing for employment purposes?

No. Testing requested by employers or testing to screen for general workplace health and safety (such as an employee “return to work” program),or testing for employment purposes are not covered by UHA plans. This aligns with UHA’s Medical Benefits Guide (MBG) and the guidance recently issued by the federal tri- agencies (U.S. departments of: Labor, Health and Human Services, and Treasury).

Eligibility and Premiums

What is ARPA?

The American Rescue Plan Act of 2021 (ARPA) was signed by President Biden in March 2021. It includes a number of provisions designed to assist workers impacted by the COVID-19 pandemic.

How does ARPA affect COBRA or impact my company?

Among the provisions of this new law is a COBRA premium subsidy that pays for 100% of the applicable COBRA premium for eligible individuals for coverage periods beginning April 1, 2021 and ending September 30, 2021.

If your group health plan is subject to COBRA, there are new COBRA notice requirements for employers and additional COBRA election opportunities for assistance-eligible individuals starting April 1, 2021.

How can I find out more about ARPA’s COBRA subsidy and this new law?

Every employer’s situation is unique, so you must consult with your business and/or legal counsel for specific advice for your company. Please note that when contacted by any members who will be impacted by this new law, we are directing them back to their former employers. Please contact your former employer.

We also suggest that employers check the U.S. Department of Labor website regularly for updates should they become available.

I may need to furlough my employees or reduce their work hours. Can I continue to provide health coverage to my employees if they fall below the minimum required hours for eligibility?

Yes, UHA will allow for continuation of coverage due to the COVID-19 pandemic. Please contact your Client Services Liaison or Coordinator at (808) 532-4000, ext. 358 or toll free 1-(800) 458-4600, ext. 358 or email [email protected].

Can the 4-week waiting period be waived for employees who re-enroll at the end of a furlough or if they are rehired?

Yes, UHA will waive waiting-period requirements for members who were furloughed or displaced due to the COVID-19 pandemic, but then later return to work. Please contact your Client Services Liaison or Coordinator for details: (808) 532-4000, ext. 358 or toll free 1-(800) 458-4600, ext. 358 or email [email protected].

Can I change my medical plan to reduce costs?

Depending on your regulatory plan status, you can change medical plans during the COVID-19 pandemic. Please keep in mind that the change may increase out-of-pocket expenses for your employees. Also, please note this is a process that does take some time; UHA must approve the change in plans and be given time to make the change. We recommend at least 60 days to properly execute the change and for you to properly notify your employees.

Can I make temporary changes to my drug, vision and dental riders to reduce costs?

Please contact your Client Services Liaison or Coordinator to determine if your plan status will allow for these changes. Depending on your regulatory plan status, you may be able to make changes to your drug, vision and dental riders. We are here to guide you as current regulations may not permit the exclusion of certain riders. Call us at (808) 532-4000, ext. 358 or toll free 1-(800) 458-4600, ext. 356 or email [email protected].

What if I cannot pay my premiums by the first of the month?

Because health plan coverage begins on the 1st of the month, Hawaii law requires premium payments to be made by that date to avoid a lapse in coverage.

If you anticipate a delay in making a premium payment, please contact one of our Billing Representatives immediately to discuss your alternatives.

UHA is required to give companies 10-day advance notice that a lapse in coverage will occur if payment is not received within the notice period. Again, if you do anticipate a delay in payment or receive a notice of impending termination of your coverage, please call us immediately to discuss payment options. We recognize that the current COVID-19 situation calls for difficult decisions; we want to work with you as every organization is facing different circumstances.

Call us at (808) 532-4000, ext. 353 or toll free 1-(800) 458-4600, ext. 353 or email billing@uhahealth.com.

Where can I find information on federal and state relief funds for small businesses?

The CARES Act was signed into federal law on March 27, 2020, to provide billions of dollars in relief for American workers and small businesses. It was designed to offer multiple funding options for those seeking relief.

This act established new temporary programs to address the COVID-19 outbreak and provide several Coronavirus relief options:

  1. Paycheck Protection Program – An SBA loan that helps businesses keep their workforce employed during the Coronavirus (COVID-19) crisis.
  2. EIDL (Economic Injury Disaster Loan) Emergency Advance – This loan advance will provide up to $10,000 of economic relief to businesses that are currently experiencing temporary difficulties.
  3. SBA Express Bridge Loan – Enables small businesses who currently have a business relationship with an SBA Express Lender to access up to $25,000 quickly.
  4. SBA Debt Relief – The SBA is providing a financial reprieve to small businesses during the COVID-19 pandemic.

For more information, please visit the U.S. Small Business Administration website.

Beginning May 18, 2020, the City and County of Honolulu launched a COVID-19 reimbursement program for small businesses called the Small Business Relief and Recovery Fund. Please click on the link for more details.

Local applications for CARES funding can be found at the following:

We recommend that you discuss these programs with your financial and/or tax professional to determine which programs might be the best option for you and your business.

Additional Resources

What mental health resources are available if I or my employees experienced mental or emotional hardship during the pandemic?

The HDOH developed a new program, Kū Makani—The Hawai‘i Resiliency Project, offering dedicated crisis counseling to callers facing emotional fallout related to the COVID-19 pandemic.

  • Kū Makani has an array of services to help residents experiencing anxiety, depression, panic or just feeling overwhelmed by the challenges of the pandemic.
  • This is a FREE service.
  • To reach a trained Kū Makani counselor, call the Hawai’I CARES
    • hotline: Oahu – (808) 832-3100
    • Neighbor Islands: Maui, Kauai, and Hawaii – 1 (800) 753-6879 Kū Makani crisis counseling hours:
      • 4:00 p.m. – 9:00 p.m. Monday-Friday
      • 9:00a.m. – 9:00 p.m. Saturday and Sunday
  • Visit the Kū Makani website and social media for detail about the program, services, upcoming events, and island-specific resources: kumakani.org
  • For non-pandemic counseling and services, including crisis support, mental health resources and substance use treatment services, you may always call the Hawai‘i CARES hotline 24/7 at 1 (800) 753- 6879 or text “ALOHA” to 741741.