My Hawaii Wellness

Welcome to Verdegard Hawaii


EUTF Supplemental Medical & Prescription Drug Plan Resource Page

This supplemental plan is available for EUTF active employees who have group health coverage under a separate non-EUTF sponsored plan (other than Medicare or Med-QUEST). Retirees and HSTA VB members are not eligible.

This low-cost plan reimburses participants for eligible out-of-pocket costs that arise from their primary medical and prescription drug plans, such as copayments and coinsurances. 

 


 

2024-2025 Helpful Links

 

Submit a Claim     |     Plan Summary     |     Exclusions    |     FAQ     |     Enrollment Guide


 

Plan Documents & Forms

Plan Summary

Current Plan Year: 7/1/2024 – 6/30/2025
View Summary


Current Plan Year: 7/1/2023 – 6/30/2024
View Summary

 
Claim Submission Form
Submit Online Claim 

 
Current Plan Year: 7/1/2024 – 6/30/2025
Download Form


Previous Plan Year: 7/1/2023 – 6/30/2024
Download Form
Exclusions List
View Exclusions List
Frequently Asked Questions (FAQ)
View FAQ’s
Supplemental Plan Document
Download Document
ACH Form 
Download Form
*Authorization to Release PHI Form  
Download Form
Privacy Practices
Download Document
Other Insurance Form
Download Form
2024-2025 Enrollment Guide
View Guide
* Your one-time authorization allows Verdegard Administrators, LLC to release your protected health information (PHI), including making payments and explanation of benefits (EOB), to a person or organization that you choose.

 


 

Contact Verdegard Hawaii

Pacific Guardian Tower
1440 Kapiolani Boulevard, Suite 1000
Honolulu, Hawaii 96814     

Hours
Monday – Friday 7:30 a.m. – 7 p.m. (HST)
Saturday 9:00 a.m. – 1:00 p.m. (HST)


Walk-in Hours:

Monday through Friday, 7:30 a.m. – 5 p.m. HST

Oahu: (808) 951-4643

Neighbor Islands: (866) 437-1992

Fax: (808) 951-4620

Web: www.verdegard-hi.com/EUTF