The Employer-Union Health Benefits Trust Fund oversees health and life insurance benefits for 171,025 public workers, retirees and their dependents. The EUTF faces about $14.5 billion in unfunded liabilities, according to the latest actuarial valuation report. That reflects the amount taxpayers owe for future retiree health benefits. The EUTF has had to seek ways to minimize the increases in premiums as it tries to provide reasonably priced benefits for public employees.
Members include 53,900 active employees, 39,285 retirees
, and 77,840 dependents, according to a fiscal 2010 audit.
Benefits include health insurance, prescription drug, dental and vision coverage as well as a chiropractic plan. Approximately $500 million is paid annually by the state for employee coverage.
The EUTF’s health plans are broken into two broad categories — self-insured and fully funded:
- Self-insured means EUTF acts as its own health insurance company of sorts – it sets and collects premiums from the state and counties and employees and oversees policy. The EUTF contracts with administrators to process claims and maintain provider networks.
The self-insured plans are administered by the Hawaii Medical Service Association (80/20 plan) and HMA (90/10). Fully insured, or health maintenance organization, plans are also available through Kaiser Permanente. InformedRx is the pharmacy benefits manager; Hawaii Dental Service and Vision Service Plan are also vendors. Coverage under the self-funded plan is much like a so-called preferred-provider program that many in Hawaii subscribe to through private insurers – a plan that allows them their choice of medical providers.
- The other part of the EUTF’s insurance offerings is a so-called fully insured plan. It involves the EUTF contracting with a managed-care organization such as Kaiser Permanente, which sets rates on its own and provides coverage and services.
Retirees’ health benefits are based on when they started working and how many years they’ve worked. Depending on when the retiree was hired and how many years of service, the plans can include coverage for spouses, domestic partners and unmarried children up to age 19.
There have been efforts to reduce the retirees benefits, with a scale being instituted on what percentage of premiums the state and counties will pay. In addition, they’ve also set a cap on premiums, requiring the retirees and active employees to make up amounts not covered by the set premium rate.
||Years of Service
||% Paid of Benefit Contribution
||Less than 10 years
||10 years or more
|On or after 7/1/1996*
||Less than 10 years
||25 or more years
*For retirees who were hired on or after 7/1/2001 the premium contribution only applies to individual plans.
The plans are funded through contributions by state and county employers and their employees. During the year that ended June 30, 2010, the state and counties contributed $513.2 million into the fund while employees contributed $160.1 million. The EUTF paid out $590.7 million in premiums and self-insured claims. Medicare Part B reimbursements for retirees accounted for an additional $44.8 million.
For employees who are union members, the share of benefit plan contributions is set by collective bargaining negotiations. The employers had contributed roughly 60 percent of the costs for the self-funded plans, with members picking up 40 percent. Lawmakers budgeted for a 50-50 split of health care costs for the fiscal years 2012 and 2013.
Hawaii is one of at least 29 states that have been on a “pay-as-you-go” system for paying retiree costs and have not set aside money for these costs in the future.
In recent years the Governmental Accounting Standards Board has required more transparency on the future costs for retiree health benefits, something that’s also known as “Other Post Retirement Benefits,” or OPEB, among accountants. Hawaii has started reporting this liability but has yet to follow some other states that are starting to set aside funds for these future costs. There is no GASB requirement that states pre-fund these expenses and Hawaii is in compliance with OPEB reporting rules for now. Some of Hawaii’s counties have started to set aside money for OPEB, but the state has yet to do so.
The EUTF faces about $14.5 billion in unfunded liabilities, according to the latest actuarial valuation report. That reflects the amount taxpayers owe for future retiree health benefits.
The Legislature created the EUTF to consolidate separate health benefit plans under its predecessor, the Hawaii Public Employees Health Fund and various union-sponsored plans. The fund was established in Chapter 87A of the Hawaii Revised Statutes and took over from the predecessor fund in July 2003.
By creating the EUTF and a single health benefits system the state hoped to address escalating health insurance costs for workers, retirees and dependents.
The EUTF is administratively attached to the state Department of Budget and Finance. An administrator reports to a board of trustees comprised of 10 members who are appointed by the governor. The board decides on the types and scope of health plans, negotiations with insurance carriers and sets other policies. Five of the trustees come from state and county employers, four from public worker unions and one from retirees. The board sometimes has difficulty reaching decisions when trustees vote along employer or employee lines, resulting in a stalemate.
The chairmanship of the board switches between union and employer representatives each year. George Kahoohanohano of the State of Hawaii Organization of Police Officers is the chairman through Dec. 2011.
- Dean Hirata, deputy director of the Department of Budget and Finance
- Loretta Fuddy, director of the Department of Health
- Audrey Hidano, deputy director of the Department of Labor and Industrial Relations
- Everett Kaneshige, deputy director, Department of Commerce and Consumer Affairs
- Sunshine Topping, director of the Department of Human Resources
Public Worker Union Trustees:
- Karolyn Mossman, Hawaii State Teachers Association
- George Kahoohanohano, State of Hawaii Organization of Police Officers
- Celeste Yip, Hawaii Firefighter Association
- Derek Mizuno, Hawaii Government Employees Association
- Clifford Uwaine, United Public Workers