§386-100 Deductible option for medical benefits in insurance policy. (a) Each workers' compensation insurance policy issued by every insurer shall offer, at the option of the insured employer, a deductible for medical benefits in the amount of $100, $150, $200, $300, $400, $500, $2,500, $5,000, or $10,000, or greater if agreed upon by the insurer and the insured employer. The insured employer, if choosing to exercise the option, shall choose only one of the amounts as the deductible. The provisions of this subsection shall be fully disclosed to the prospective purchaser in writing.
(b) If an insured employer exercises the option and chooses a deductible, the insured employer shall be liable for the amount of the deductible for the medical benefits paid for each claim of work injury suffered by an injured employee. The insurer shall not be liable for the deductible.
The insurer shall pay the entire cost of medical bills directly to the provider of services and then seek reimbursement from the insured for the deductible amount.
Deductible medical benefit amounts shall be reported by insurers as required by section 386-95 and shall be included in the total average annual compensation paid by all insurance carriers in determining the charge against employers not insured under section 386-121(a)(1) for the purpose of the special compensation fund. [L 1985, c 296, §13; am L 1989, c 243, §1; am L 1995, c 234, §17]
Structure Hawaii Revised Statutes
Title 21. Labor and Industrial Relations
386. Workers' Compensation Law
386-2 Definitions relating to family relationships.
386-5 Exclusiveness of right to compensation; exception.
386-6 Territorial applicability.
386-7 Interstate and foreign commerce and maritime employment.
386-8 Liability of third person.
386-8.5 Limits of third party liability.
386-9 Contracting out forbidden.
386-10 Out of state employers.
386-21 Medical care, services, and supplies.
386-21.5 Publication of fees by prepaid health care plan contractors.
386-21.7 Prescription drugs; pharmaceuticals.
386-22 Artificial member and other aids.
386-23.5 Services of attendant, allowance adjustments.
386-23.6 Weekly benefit adjustments for recipients of services of attendants.
386-24 Medical rehabilitation.
386-25 Vocational rehabilitation.
386-26 Guidelines on frequency of treatment and reasonable utilization of health care and services.
386-27 Qualification and duties of health care providers.
386-28 Opioid therapy; qualifying injured employees; informed consent process.
386-29 Qualifying injured employees; initial concurrent prescriptions; opioids and benzodiazepines.
386-33 Subsequent injuries that would increase disability.
386-41 Entitlement to and rate of compensation.
386-43 Duration of dependents' weekly benefits.
386-44 Effect of erroneous payment; insanity of beneficiary.
386-51 Computation of average weekly wages.
386-51.5 Limited liability in concurrent employment.
386-52 Credit for voluntary payments and supplies in kind.
386-53 Nonweekly periodic payments.
386-54 Commutation of periodic payments.
386-55 Trustee in case of lump sum payments.
386-56 Payment from the special compensation fund in case of default.
386-57 Legal status of right to compensation and compensation payments.
386-71 Duties and powers of the director in general.
386-73 Original jurisdiction over controversies.
386-73.5 Proceedings to determine employment and coverage.
386-79 Medical examination by employer's physician.
386-80 Examination by impartial physician.
386-81 Notice of injury; waiver.
386-82 Claim for compensation; limitation of time.
386-83 When claim within specified time is unnecessary or waived.
386-84 Limitation of time with respect to minors and mentally incompetent.
386-86 Proceedings upon claim; hearings.
386-87 Appeals to appellate board.
386-87.1 Standing to intervene in appeals.
386-89 Reopening of cases; continuing jurisdiction of director.
386-90 Conforming prior decisions on appeal.
386-91 Enforcement of decisions awarding compensation; judgment rendered thereon.
386-92 Default in payments of compensation, penalty.
386-94 Attorneys, physicians, other health care providers, and other fees
386-95 Reports of injuries, other reports, penalty.
386-96 Reports of physicians, surgeons, and hospitals.
386-98 Fraud violations and penalties.
386-99 Posting of information.
386-100 Deductible option for medical benefits in insurance policy.
386-121 Security for payment of compensation; misdemeanor.
386-123 Failure to give security for compensation; penalty; injunction.
386-124 The insurance contract.
386-124.5 Insurer's requirements; failure to maintain claims service office; penalty; injunction.
386-125 Knowledge of employer imputed to insurance carrier.
386-126 Insolvency of employer not to release insurance carrier.
386-127 Cancellation of insurance contracts.
386-128 Insurance by the State, counties, and municipalities.
386-129 Employees not to pay for insurance; penalty.
386-142 Employment rights of injured employees.
386-151 Special compensation fund established and maintained.
386-152 Levy and charges to finance special compensation fund.
386-153 Levy on insurers of employers insured under section 386-121(a)(1).
386-154 Charge against employers not insured under section 386-121(a)(1).
386-154.5 Special assessments.
386-161 Who entitled to compensation.
386-171 Volunteer personnel, medical, etc., expenses.
386-172 Administration and procedure.
386-173 Time for giving notice, etc.
386-193 Authority to act as workers' compensation self-insurance group.
386-195 Certificate of approval; termination.
386-197 Board of trustees; membership, powers, duties, and prohibitions.
386-198 Group membership; termination, liability.
386-201 Financial statements and other reports.
386-202 Misrepresentation prohibited.
386-204 Rates and reporting of rates.
386-206 Premium payment; reserves.
386-207 Deficits and insolvencies.
386-210 Cease and desist orders.