Hawaii Temporary Disability Insurance - Legislative Guidance

Table of Contents

Overview
Employer Coverage
Employee Eligibility
Qualifying Absence Reasons and Leave Duration
How Leave Can be Taken
Certification Requirements
Pay and Benefits
Interaction with Other Laws
Employee and Employer Responsibilities
Resources

Overview

Hawaii Temporary Disability Insurance (HITDI) offers wage replacement benefits due to the employee’s injury, illness or pregnancy.

HITDI is not administered by the state. Instead, employers must choose how they wish to provide coverage under the law by either choosing from a list of authorized insurance providers, an employer equivalent or self-insured plan, or through any collective bargaining agreement (CBA) that offers the equivalent benefits. The employer or the approved authorized insurance provider manages the claims and decisions to make payment. Employers may choose to withhold payroll contributions, but it is not required.

There are minimums for wage replacement that are required by law, which may change year over year. Eligible employees may receive benefits up to 26 weeks.

AbsenceSoft Policies

Hawaii Temporary Disability Insurance is configured in AbsenceSoft with the policy code and naming below:

• Hawaii Temporary Disability Insurance HI-STD

Legislation codes and statues

The information presented in the guidance relates to the following legislative codes, links to the specific legislation can be found within the ‘Resources’ section of this document:

• Hawaii Revised Statues Chapter 392, et al (Haw. Rev. Stat. §392)

Employer Coverage

Any employer doing work in Hawaii that employs one or more individuals for any portion of any day.

Exceptions:

• Some federal workers

• Political subdivisions not operating within the state

• Some non-profit workers and student workers

• Domestic service workers earning less than $225

• Uncustomary work where wages are less than $50 with exceptions of per diems, vessels, fishing or merchant vessels

• Employees who work for their family members (child, spouse, parent)

• Newspaper employees under 18

• Certain salespersons earning commission (real estate agents, insurance agents, etc.)

• Independent contractors (those with at least 50% ownership in a corporation, LLC, partnership or sole proprietorship)

Employee Eligibility

An employee must have worked for any employer at least 14 or more weeks, received earnings in any form for 20 or more hours of work and earned at least $400 during the 52 weeks preceding the first day of disability.¹

An employee must also have been in employment for at least two weeks before disability to be able to claim benefits. Employees who may have just started new employment may be eligible for HITDI at the new employer.²

Qualifying Absence Reasons and Leave Duration

Employees may claim up to 26 weeks of disability in any benefit year. Benefit year varies depending on prior usage.

If there is just one claim in a year, the benefit period begins on a rolling forward basis beginning with the first day of disability. When the claim crosses benefit years, the start of the new benefit year depends on when the disability starts or when the old year ends and whether benefits are still being paid in the last week of the previous claim year.

Medical Care

• Employee Health Condition: Care for the employee’s own serious health condition due to accident, injury or illness.

• Pregnancy/Maternity: Pregnancy disability, and/or pregnancy complications, pregnancy termination, any injury or illness associated with pregnancy.

• Organ Donation: donation of an organ.

How Leave Can be Taken

Leave may only be taken consecutively for any qualifying reason.

• Consecutive leave: A continuous, uninterrupted period of leave taken for a single qualifying reason.

Certification Requirements

Employees must file for benefits through their employer or approved third-party administer, and receive their certification forms through the claims process. Employees may also contact the state to obtain a certification form. Employees must file claims within 90 days of the disability event, otherwise the employee may lose wage replacement benefits.

Pay and Benefits

Where state pay benefits are involved with other law interactions, such as state mandated sick pay, employers will want to consider where PTO/employer pay benefit application should occur. There is a 7 calendar day waiting period before benefits begin. If the employee goes out for the same condition and the time between is less than two weeks, there is no new waiting period.

Amount of Pay

HITDI pays a weekly benefit amount that is determined by comparing the employee’s average weekly wage to the state’s average weekly wage. Benefits are calculated on a sliding scale, with lower-income employees generally receiving more of their usual wages compared to higher-income employees. Minimum and maximum weekly benefit amounts are based on the state average weekly wage (SAWW). SAWW are updated periodically by the state and may change year over year. Employers will want to review the state website for further information on the current SAWW.

💡 There are special rules for some teachers where they may be eligible for multiple benefit programs.³

Use of Paid Time Off (PTO)/Employer Benefits

The regulations do not speak about the use of coordinating employer sponsored benefits such as paid time off, vacation or sick pay. Employers will want to review their policies and procedures.

Job Protection

The law provides wage protection benefits, not job protection.

Other Protections

No other protections are mentioned in the regulations.

Benefits

Benefits are not discussed in the regulations.

Interaction with Other Laws

Where an employee meets the definition of family member, qualifying absence reason, or serious health condition, the state and federal laws may interact. Accommodations that are not leave related, would not run concurrently with other state or federal leave laws.

Family and Medical Leave Act (FMLA)

HITDI can run concurrently with FMLA.

Hawaii Pregnancy Disability Leave (HIPDL)

HITDI can run concurrently with HIPDL.

Hawaii Donation Leave (HIDONOR)

HITDI can run concurrently with HIDONOR depending on the situation and event.

Unemployment

Employees receiving unemployment are not eligible for HITDI.

Workers’ Compensation

Employees are not eligible for HITDI for work place injuries. However, there may be situations where workers’ compensation benefits are denied and the employee would then be able to file for HITDI benefits.

💡 If the employee is receiving payment from another state’s disability or PFML program, the employee is not entitled to benefits under HITDI.

Employee and Employer Responsibilities

Employee Responsibilities

• Notify employer and file a claim within 90 days;

• Contact employer or state for certification forms;

• Follow any appeals processing where applicable;

• Follow employer policies and procedures for time off reporting.

Employer Responsibilities

• Posting requirements are as follows and all posters must be a place that is conspicuous/frequented by employees:

  • Employers are required to post notice they have obtained insurance coverage to provide TDI benefits under the law.

• Employers must notify the department and the employee of any benefit denials using a prescribed form;

• Determine how the TDI benefits will be administered and any payroll contribution withholdings;

• Determine if wage replacement payments will be more than offered under the law;

• Insurance providers chosen by the employer must consider all employment where the employee may hold more than one job - employers may need to review situations, audits, reimbursements, etc for managing the insurance providers;

• Notify the department when changes to carriers, administration changes, lapses in coverage occur;

• Supply employees with required certification form, ensure third party supplies the form, or direct the employee to the state for the form;

• Employers are required to submit information (wages, hours, employment length, etc.) to any third party administrator within seven days from request; and

• Respond to requests from department for appeals/denials.

Resources

• Hawaii Legislation: https://www.capitol.hawaii.gov/hrscurrent/Vol07_Ch0346-0398/HRS0392/HRS_0392-.htm

• Hawaii Temporary Disability state resources: https://labor.hawaii.gov/dcd/home/about-tdi/

Footnotes:

1. Haw. Rev. Statues §392-25

2. Haw. Rev. Statues §392-6

3. Haw. Rev. Statues §392-21