Haw. Rev. Stat. § 392-42

If payment of disability benefits is provided for in whole or in part by insurance pursuant to section 392-41(a)(1), (4), or (5), the employer or insurer shall forthwith file with the director in form prescribed by the director a notice of the employer's or insurer's insurance together with a statement of benefits provided by the policy. If an employer or insurer fails to file the notice of insurance within thirty days after purchase of insurance, the director may levy a penalty of not more than $10 for each delinquent notice, unless good cause for failure to file can be shown by the employer or insurer.