| RCUH Monthly Premium Rate Sheet — Active Employees | 3.520, 3.520A |
| RCUH Monthly Premium Rate Sheet — COBRA | 3.285, 3.520, 3.520A |
| Benefits at a Glance | |
| Benefits Summary by FTE (Regular and Non-Recruited) | |
| Guide to Benefits - Regular Status Employees | |
| New Hire: Benefits Information Important Dates to Know One-Pager | |
| New Hires FAQs | |
| Active Employees FAQ | |
| RCUH Medical Plan Comparison - Active Employees | |
| RCUH Open Enrollment All-in-One Form (OE-B5) | |
| Group Health Insurance Enrollment/Change Form: Regular-Status Employees (B-5H) | |
| Group Health Insurance Waiver Form: Regular-Status Employees (B-5Wb) | |
| Group Health ACA Insurance Enrollment/Change/Waive Form: Non-Recruited Employees (B-5A) | |
| RCUH New Hire Worksheet | |
| MEDICAL PROVIDER INFORMATION - HAWAII MEDICAL SERVICE ASSOCIATION (HMSA) | |
| HMSA Benefits Summary All Plans | |
| HMSA CompMed Basic - Summary of Benefits & Coverages | |
| HMSA CompMed - Summary of Benefits & Coverages | |
| HMSA PPO - Summary of Benefits & Coverages | |
| HMSA HMO - Summary of Benefits & Coverages | |
| HMSA CompMed Basic - Guide to Benefits | |
| HMSA CompMed - Guide to Benefits | |
| HMSA PPO - Guide to Benefits | |
| HMSA HMO - Guide to Benefits | |
| HMSA PPO Plan Type - Drug Rider | |
| HMSA HMO Plan Type - Drug Rider | |
| HMSA Active & Fit Direct Program | |
| HMSA Complementary Care - 24-25 | |
| MEDICAL PROVIDER INFORMATION: KAISER PERMANENTE HAWAII | |
| Kaiser RCUH Benefit Highlights | |
| Kaiser Standard (Plan A) Summary of Benefits | |
| Kaiser Standard (Plan A) Guide to Health Plan | |
| Kaiser Standard (Plan A) Benefit and Payment Chart | |
| Kaiser Comprehensive (Plan B) Summary of Benefits | |
| Kaiser Comprehensive (Plan B) Guide to Health Plan | |
| Kaiser Comprehensive (Plan B) Benefit and Payment Chart | |
| Kaiser CAM+N Flyer | |
| 5 Great Reasons to Choose Kaiser Permanente | |
| Getting Started with Kaiser Permanente | |
| Kaiser Away from Home Care Options | |
| Kaiser Fit Rewards & FAQ | |
| Kaiser Mail-Order Pharmacy | |
| Kaiser Mental Health & Wellness | |
| Kaiser Online Tools Brochure | |
| Kaiser Optical 150 | |
| Kaiser Out of Area Dependent Coverage | |
| DENTAL PROVIDER INFORMATION - HAWAII DENTAL SERVICE (HDS) | |
| HDS Benefits Summary | |
| HDS Information Packet | |
| HDS SmileWell Overview | |
| DISCLOSURES & COVERAGE NOTICES | |
| Creditable Coverage Disclosure Notice | |
| 2024 Personnel Action & Payroll Calendar | |
| 2024 Personnel Action & Payroll Schedule | |
| 2025 Personnel Action & Payroll Calendar | |
| 2025 Personnel Action & Payroll Schedule | |
| State and Federal Employment Law Poster (2023) | |
| EEO Complaint Form (O-3) | 3.110, 3.120 |
| Equal Employment Opportunity Policy Statement | 3.110 |
| RCUH Withdrawal of Complaint and Release Form (O-4) | 3.110, 3.120 |
| Attestation of Exception to EIC Review (No RCUH HR Review needed) - Form ICQ-01 | 3.225 |
| Independent Contractor Questionnaire (ICQ): Request for RCUH HR Review - Form ICQ-02 | 3.225 |
| Independent Contractor Memo Template | 3.225 |
| Independent Contractor Memo - Instructions | 3.225 |
| Guest Speaker Memo Template | 3.225 |
| Guest Speaker Memo - Instructions | 3.225 |
| Master EIC Determination - Non-Employee Research Study Participant | 3.225 |
| Master EIC Determination - Non-Employee Non-Compensated Project Support | 3.225 |
| Master EIC Determination - Non-Employee Special Duty Police | 3.225 |
| Employees - Completing an eTimesheet (Standard) | |
| Principal Investigators - Approving eTimesheets (Standard) | |
| Employees - Completing an eTimesheet (Task Order) | |
| Principal Investigators - Approving eTimesheets (Task Order) | |
| Acknowledgement - Receipt of Company Property Financial Obligation Form (O-6) | |
| Ethics Checklist | 3.210 |
| Ethics Guide | 3.210 |
| Form I-9 with RCUH Address | |
| New Hire Reference Guide (for Non-Recruited Hires) | 3.005 |
| New Hire Reference Guide (for Regular Hires) | 3.005 |
| Personnel Action Form | 3.342, 3.350, 3.360, 3.620, 3.674 |
| Student Assistant Pay Schedule | 3.211 |
| HR Portal Access Form — Existing DC | 3.710 |
| HR Portal Access Form — New DC | 3.710 |
| How to Fill Out an HR Portal Access Form: Existing DC | 3.710 |
| How to Fill Out an HR Portal Access Form: New DC | 3.710 |
| RCUH User Acknowledgement | 3.710 |
| Part A - HR Portal User Guide - Overview | 3.710, 3.810 |
| Part B - HR Portal User Guide - Recruitment & Employment I | |
| Part C - HR Portal User Guide - Recruitment & Employment II | |
| Part D - HR Portal User Guide - Payroll | |
| Part E - HR Portal User Guide - HR Information Systems I | |
| Part F - HR Portal User Guide - HR Information Systems II | 4.400 |
| Confidentiality Requirements for Personal Identifiable Information Acknowledgement Form | 3.480 |
| Memo - Unforeseen Disruption in Work Schedules | 3.262 |
| Model RCUH Safety Program | 3.930 |
| Supervisors Report of Industrial Injury Form | 3.930 |
| RCUH 12-Month/Needs Based Performance Evaluation Short Form (Excel Format) | 3.410 |
| RCUH 12-Month/Needs Based Performance Evaluation Long Form (Excel Format) | 3.410 |
| Attachment B User Guide | 3.234 |
| Common External Publications | 3.234 |
| Manual PRF - Change Account Number | 3.234 |
| Manual PRF - Ads | 3.234 |
| RCUH Recruitment Procedure | 3.234 |
| Employment of Relatives & Other Close Relationships Form | 3.255, 3.262 |
| Interview Comment Sheet | 3.235 |
| Job Description Template | 3.234 |
| Position Requisition Form | 3.234 |
| RCUH Certification of Compliance - Prospective New Hire | |
| Telephone Reference Check Form | 3.235 |
| HMSA Akamai Advantage Form | 3.550 |
| HMSA Automatic Payment Application | 3.550 |
| HMSA Authorized Contact Form | 3.550 |
| HMSA Akamai Advantage Summary of Benefits | 3.550 |
| Kaiser Senior Advantage Form | 3.550 |
| Kaiser Automatic Payment Application | 3.550 |
| Kaiser Senior Advantage Summary of Benefits | 3.550 |
| MetLife Life Insurance Policy (RCUH Retirees) | 3.550 |
| Termination of Employment Form | 3.285 |
| Termination General Information (Regular, Non-Regular, Relief status employees) | 3.285 |
| Termination General Information (Non-Recruited Employees) | 3.285 |
| COBRA Monthly Rate Sheet (Medical and Dental premiums): Effective 07/01/2021 - 06/30/2022 | 3.285 |
| COBRA Notification - For reference only (actual notification to be sent upon processing of termination action) | 3.285 |
| HDS (Dental) COBRA Enrollment Form | 3.285 |
| Kaiser (Medical) COBRA Enrollment Form | 3.285 |
| UNUM (Long Term Care) Continuation of Coverage Application | 3.285 |
| MetLife (Life Insurance) Portability Application | 3.285 |
| MetLife (Life Insurance) Conversion Application | 3.285 |
| NBS (Flexible Spending Healthcare) Continuation of Coverage Application | 3.285 |
| TIAA (Retirement Account) Options When Terminating with RCUH | 3.285 |
| RCUH Mahalo Survey | 3.285 |
| Employee Time/Leave Certification Form | 3.340, 3.342, 3.344, 3.620, 3.640, 3.650, 3.670, 3.672, 3.674, 3.676, 3.678 |
| RCUH Request for Timesheet Correction Form | 3.810 |
| Dependent Information Form | 3.212 |
| E-3 Request Form | 3.212 |
| H-1B Request Form | 3.212 |
| J-1 Change Form | 3.212 |
| J-1 Completion Form | 3.212 |
| J-1 Request Form | 3.212 |
| J-2 Information Form | 3.212 |
| O-1 Request Form | 3.212 |
| RCUH Pre-Arrival and Orientation Information for J-1 Exchange Visitors | 3.212 |
| TN Request Form | 3.212 |
| Belgium (Research) | |
| Bulgaria (Research) | |
| China (Research) | |
| Commonwealth of Independent States (Research) | |
| Czech Republic (Research) | |
| Egypt (Research) | |
| France (Research) | |
| Germany (Research) | |
| Greece (Research) | |
| Hungary (Research) | |
| India (Research) | |
| Indonesia (Research) | |
| Israel (Research) | |
| Italy (Research) | |
| Jamaica (Research) | |
| Korea (Research) | |
| Luxembourg (Research) | |
| Netherlands (Research) | |
| Norway (Research) | |
| Pakistan (Research) | |
| Phillipines (Research) | |
| Portugal (Research) | |
| Romania (Research) | |
| Slovak Republic (Research) | |
| Slovenia (Research) | |
| Thailand (Research) | |
| Trinidad & Tobago (Research) | |
| United Kingdom (Research) | |
| Venezuela (Research) | |
| Belgium (Student) | |
| Bulgaria (Student) | |
| China (Student) | |
| Cyprus (Student) (Student) | |
| Czech Republic (Student) (Student) | |
| Egypt (Student) (Student) | |
| Estonia (Student) (Student) | |
| France (Student) (Student) | |
| Germany (Student) | |
| Iceland (Student) | |
| Indonesia (Student) | |
| Israel (Student) | |
| Latvia (Student) | |
| Lithuania (Student) | |
| Morocco (Student) | |
| Netherlands (Student) | |
| Norway (Student) | |
| Pakistan (Student) | |
| Phillipines (Student) | |
| Poland (Student) | |
| Portugal (Student) | |
| Romania (Student) | |
| Slovak Republic (Student) | |
| Slovenia (Student) | |
| Spain (Student) | |
| Thailand (Student) | |
| Trinidad & Tobago (Student) | |
| Tunisia (Student) | |
| Venezuela (Student) | |
