EUTF and Medicare for Hawaii state retirees

Hawaii has the largest per-capita state government workforce in the country. For State of Hawaii and county retirees aging into Medicare, the Employer-Union Health Benefits Trust Fund (EUTF) provides retiree health coverage that coordinates closely with Medicare — and reimburses the Part B premium for many retirees.

Who EUTF covers

EUTF provides health benefits for active and retired employees of:

• The State of Hawaii (executive, legislative, and judicial branches)
• The four county governments — City & County of Honolulu, Hawaii County, Maui County, and Kauai County (Kalawao County is administered by the Hawaii Department of Health rather than its own county government)
• The University of Hawaii system
• The Department of Education (including HSTA-VB members)
• The Hawaii Health Systems Corporation
• Other participating public employers

If you're a retired state, county, or DOE employee in Hawaii — or a surviving spouse — EUTF is likely your retiree health coverage.

Medicare Part B is mandatory for EUTF retiree coverage

This is the most important EUTF rule: If you're Medicare-eligible (typically age 65 or qualifying disability), you must enroll in Medicare Part B to keep EUTF retiree medical and prescription drug coverage. The same rule applies to your Medicare-eligible spouse, domestic partner, or civil union partner if covered as a dependent.

This is similar to the TRICARE For Life rule — EUTF coordinates with Medicare and requires Part B as the foundation.

EUTF reimburses your Medicare Part B premium

Here's the substantial benefit: EUTF reimburses Medicare-eligible retirees for the standard Medicare Part B premium. In 2026, that's $202.90/month — about $2,435/year that EUTF reimburses to you.

How it works:

• If you're paying the standard Part B premium and were reimbursed for 2025, EUTF automatically updates your reimbursement for 2026 — no paperwork needed
• If you pay a higher premium because of IRMAA (income-related monthly adjustment amount), submit your SSA letter to EUTF and they'll reimburse the higher amount (less any penalties)
• Reimbursement appears as a credit toward your EUTF premium or by direct deposit, depending on your situation

This effectively makes Part B nearly free for EUTF retirees — a major financial benefit on top of EUTF coverage itself.

2026 EUTF Medicare retiree plan options

EUTF Medicare-eligible retirees choose from:

• HMSA 90/10 PPO with Medicare — works with Original Medicare, with HMSA covering most of what Medicare doesn't
• Humana Medicare Advantage — bundled MA plan replacing Original Medicare, with EUTF coverage layered on
• Kaiser Permanente Senior Advantage HMO — Kaiser's MA plan

Prescription drug coverage:

• CVS Caremark / SilverScript (with HMSA) — EUTF's standard Part D coverage
• Kaiser (built into the Senior Advantage plan)

Dental and vision are the same for Medicare and non-Medicare retirees — Hawaii Dental Service for dental, Vision Service Plan for vision.

How EUTF coordinates with Medicare

For HMSA 90/10 PPO retirees:

1. Medicare pays first for Medicare-covered services (Part A and Part B)
2. HMSA pays second, covering most of Medicare's deductibles and coinsurance
3. You typically pay $0 or low copays for in-network covered services

For Humana MA or Kaiser Senior Advantage:

1. The MA plan replaces Original Medicare
2. EUTF wraps around with reduced copays and additional benefits
3. The plan handles Medicare and EUTF benefits as an integrated package

Enrollment timing

Critical EUTF retiree enrollment rules:

• EC-2 Enrollment Form due within 60 days of retirement — miss this deadline and you may lose retiree coverage entirely
• Submit your ERS Retirement Estimate Letter with the EC-2 form
• If turning 65 already retired, submit your Medicare card and complete the Medicare retiree forms
• Late enrollment in Medicare Part B can result in permanent late enrollment penalties (10% per year of delay)

Spouse and dependent coverage

• EUTF covers legal spouses, domestic partners, and civil union partners
• Children up to age 26 (with specific rules for adult disabled children)
• If both spouses are EUTF-eligible (active or retired), only one can enroll in 2-Party or Family — both can enroll in Self plans
• A Medicare-eligible spouse must enroll in Part B to remain covered as an EUTF dependent

Should you keep EUTF or go Medicare-only?

For most EUTF retirees, keeping EUTF makes sense because:

• EUTF reimburses your Part B premium ($2,435+/year)
• HMSA 90/10 with Medicare provides Medigap-like coverage at often lower cost
• Prescription drug coverage is built in
• Dental and vision are included
• You don't need to shop and choose individual plans every year

Some retirees do explore individual Medicare options if their EUTF premium share is high or they prefer different network options. This is a complex decision — work with a Sage PLUS counselor or licensed agent to compare carefully.

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