Reciprocal Beneficiary Relationships

A reciprocal beneficiary relationship is a legal relationship created when two consenting adults who are prohibited from marriage declare their intent to enter a reciprocal beneficiary relationship. Neither of the parties may be married or a party to another reciprocal beneficiary relationship. Those persons desiring to enter into a reciprocal beneficiary relationship must register their relationship as reciprocal beneficiaries with the Department of Health. All requirements of the Hawaii Revised Statutes, Chapter 572C must be met.

Either party to a reciprocal beneficiary relationship may terminate the relationship by filing a signed, notarized declaration of termination of the reciprocal beneficiary relationship with the Department of Health.

The Department of Health is responsible only for registering the declaration and/or termination of reciprocal beneficiary relationships. The Department of Health neither makes any determination of the validity of the reciprocal beneficiary relationship nor is an information source on the rights and benefits extended to reciprocal beneficiaries or the consequences of the termination to the former reciprocal beneficiaries.

Eligibility

In order to enter into a valid reciprocal beneficiary relationship, it shall be necessary that:

  • Each of the parties is at least 18 years old;
  • Neither of the parties is married nor a party to another reciprocal beneficiary relationship;
  • The parties are legally prohibited from marrying one another under HRS chapter 572;
  • Consent of either party to the reciprocal beneficiary relationship has not been obtained by force, duress, or fraud; and
  • Each of the parties sign a declaration of reciprocal beneficiary relationship as provided in HRS section 572C-5.

How to Register a Reciprocal Beneficiary Relationship

  • Prepare and file a Registration of Reciprocal Beneficiary Relationship Form with the Department of Health.
  • The form must be signed by both parties and notarized. Contact your local bank about notary public services.
  • A fee of $8.00 must be paid at the time of the filing of the registration form. Payment must be in the form of money order or cashier’s check only made payable to the State Director of Finance. No cash or personal checks will be accepted.
  • At least one stamped, self-addressed, legal-sized envelope must be provided along with the registration form. Two stamped, self-addressed, legal-sized envelopes must be provided if the two certificates (see below) are to be sent to two different addresses.
  • The notarized Registration form, payment, and envelope must be sent by postal mail to:

State Department of Health
Office of Health Status Monitoring
ATTN:  RBR OFFICE
PO Box 3378
Honolulu, HI  96801

  • After being registered, two Certificates of Registration of Reciprocal Beneficiary Relationship (one for each party) will be sent by postal mail using the provided stamped, self-addressed, legal-sized envelope(s).
  • Registration forms will not be accepted and certificates of registration will not be issued on a walk-in basis.
  • Copies of the Certificate of registration are available upon written request, sent to the same address listed above, at a fee of $8.00 per copy (payment must be made in the same manner as for the initial registration), and a stamped, self-addressed, legal-sized envelope must be provided along with the request and payment.

How to File a Declaration of Termination of Reciprocal Beneficiary Relationship

  • Prepare and file a Declaration of Termination of Reciprocal Beneficiary Relationship Form with the Department of Health.
  • The Declaration of Termination form must be signed by either of the parties and notarized. Contact your local bank about notary public services.
  • A fee of $8.00 must be paid at the time of the filing of the Declaration of Termination form. Payment must be in the form of money order or cashier’s check only made payable to the State Director of Finance. No cash or personal checks will be accepted.
  • At least one stamped, self-addressed, legal-sized envelope must be provided along with the Declaration of Termination form. Two stamped, self-addressed, legal-sized envelopes must be provided if the two certificates (see below) are to be sent to two different addresses.
  • The notarized Declaration of Termination form, payment, and envelope(s) must be sent by postal mail to:

State Department of Health
Office of Health Status Monitoring
ATTN:  RBR OFFICE
PO Box 3378
Honolulu, HI  96801

  • After filing, two Certificates of Termination of Reciprocal Beneficiary Relationship (one for each party) will be sent by postal mail using the provided stamped, self-addressed, legal-sized envelope(s).
  • Declarations of Termination will not be accepted and Certificates of Termination will not be issued on a walk-in basis.
  • Copies of the Certificate of Termination of Reciprocal Beneficiary Relationship are available upon written request, sent to the same address listed above, at a fee of $8.00 per copy (payment must be made in the same manner as for the initial registration), and a stamped, self-addressed, legal-sized envelope must be provided along with the request and payment.

Forms