HAR §12-12-1. Definitions

As used herein: "Continuation of coverage in case of inability to earn wages" means that allocation of health care premium will be based on an employee's continuing salary, if this be the case, or the salary or wages that the employee received in the last fully completed month prior to the disability. Thus, the employer must continue the coverage by paying for the employer's share of the premium and the employee must contribute towards the premium to the same extent as prior to the disability. "Covered employee" means an eligible employee who is provided health care coverage by an employer. "Department" shall be as defined in section 393-3, HRS. "Director" shall be as defined in section 393-3, HRS. "Eligible employee" means an employee who has worked for an employer for twenty or more hours a week for four consecutive weeks, and earned 86.67 times the Hawaii minimum hourly wage. "Employer" shall be as defined in section 393-3, HRS. "Employment" shall be as defined in section 393-3, HRS, and shall include the period an employee is receiving benefits under chapters 386 or 392, HRS, for a period of not less than that prescribed in section 393-15, HRS. It shall also include services performed by an individual for wages or under any contract of hire irrespective of whether the common-law relationship of master and servant exists unless and until it is shown to the satisfaction of the director that: (1) The individual has been and will continue to be free from control or direction over the performance of the service, both under the contract of hire and in fact; (2) The service is either outside the usual course of the business for which the service is performed or that the service is performed outside of all the places of business of the enterprise for which the service is performed; and DLIR 12-12 Page 2 (3) The individual is customarily engaged in an independently established trade, occupation, profession or business of the same nature as that involved in the contract of service. "Four consecutive weeks" means any consecutive period of four weeks which an employee worked for an employer. "Health care contract" means the entire approved plan of the health care contractor including its terms and conditions and benefit schedule. "Premium" shall be as defined in section 393-3, HRS. "Prepaid health care contractor" shall be as defined in section 393-3, HRS. "Prepaid health care plan" shall be as defined in section 393-3, HRS. Prepaid health care plans which have the largest number of subscribers in the State are on file with the state department of labor and industrial relations, disability compensation division, and are available upon request. "Regular employee" shall be as defined in section 393-3, HRS, but does not include dependents of an employee who are covered by a health care plan as an employee of the same employer. "Regular wages" include an employee's disability income insurance provided for and paid entirely by the employer in excess of that required by any law. "Seasonal employment" means employment by an employer defined in the second sentence of section 393-3(8), HRS, during its seasonal period or seasonal periods. "Seasonal period or "seasonal periods" means the period or periods of seasonal activity of less than an aggregate of twenty-six calendar weeks in twelve consecutive calendar months in which the volume of employment by the employer in the pursuit, measured in terms of average weekly man hours per week, is at least fifty percent more than the average weekly man hours of employment by the employer in the twelve consecutive weeks in such twelve consecutive calendar months when the volume of employment by the employer is the lowest in such pursuit; provided that employment by an employer in seasonal pursuit engaged in the cultivating, harvesting, and processing of coffee and macadamia nuts and other crops or products constitutes seasonal employment during the employer's seasonal period or seasonal periods, provided further that employment during the seasonal period or seasonal periods by an employer engaged in the cultivating, harvesting, processing, canning, and warehousing of pineapples constitutes seasonal employment. "Self-insurer" means an employer as defined in section 393-3, HRS, who undertakes to provide the prescribed coverage and benefits directly to the employees without the intervention of a plan provided by a health care contractor or insurer subject to the insurance laws of the State. "Statute" means chapter 393, HRS, entitled "Prepaid Health Care Act." "Wages" shall be as defined in section 393-3, HRS. "Week" means a period of seven consecutive days based on the established work week of each employer. [Eff: 5/7/81; am 9/16/85; am 1/13/92; am 8/19/96] (Auth: HRS §393-32) (Imp: HRS §§393-1, 393-3, 393-4, 393-5, 393-7, 393-11, 393-15)