News & Announcements

Health Insurance Waiver: Updated Form HC-5 for 2020 Is Now Available

Published Tuesday, September 17, 2019 6:27 am



Hawaii’s Department of Labor and Industrial Relations Disability Compensation Division recently published Form HC-5 Employee Notification to Employer for Calendar Year 2020, available here.  Employers must ensure employees who choose to waive health care coverage under Hawaii’s Prepaid Health Care Act, complete Form HC-5 annually.  Companies with employees who waived coverage in 2019 should follow up with these employees.  If employees intend to waive coverage in 2020, they should indicate as such on the 2020 HC-5 form.  Employers must keep the signed Form HC-5 and give a copy to the employee.

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