RCUH Policies and Procedures

RCUH Retiree Monthly Premium Rate Sheets

Related Information
RCUH Retiree Monthly Premium Rate Sheet: January - June
RCUH Retiree Monthly Premium Rate Sheet: July - December

Active Employees Transitioning to RCUH Retiree Status

Forms/Related Information
RCUH Retiree Guide - LINK PENDING
RCUH Retiree Planning Template
RCUH Retiree Group Health & Life Insurance Initial Enrollment Application (Form B-27)
MetLife Life Insurance Policy (RCUH Retirees)
TIAA (Retirement Account) Options When Terminating with RCUH

Active RCUH Retirees (no longer employed by RCUH)

Forms/Related Information
RCUH Open Enrollment Retiree Group Health & Life Insurance Enrollment - LINK PENDING
Contact Information Update Form

Retiree Hawaii Medical Service Association (HMSA)

Forms/Related Information
HMSA Akamai Advantage Summary of Benefits
HMSA Akamai Advantage Form
HMSA Automatic Payment Application
HMSA Authorized Contact Form
HMSA Form of Appeals
HMSA AA Vaccination Appeals Process

Retiree Kaiser Permanente (HMO)

Forms/Related Information
Kaiser Senior Advantage Summary of Benefits
Kaiser Senior Advantage Form
Kaiser Automatic Payment Application