October 18, 2022 • News

2023 HC-5 Employee Notification to Employer Available Online

The 2023 Form HC-5 (Employee Notification to Employer) is available onlineĀ at the Hawaii Department of Labor and Industrial Relations (DLIR) website. Use this form if the employee works at least 20 hours per week and:

To download the form, visit the DLIR site. https://labor.hawaii.gov/dcd/files/2022/09/HC-5-2023.pdf

For more information on Prepaid Health Care in Hawaii, visit the DLIR PHC FAQ page.