Hawaii health field underwriting and other concepts practice questions
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On the Hawaii Accident and Health exam's general part, section IV, Other Insurance Concepts, has 5 questions and section V, Field Underwriting Procedures, has 8. [1] Section IV lists total, partial, recurrent and residual disability; owner's rights; dependent children benefits; primary and contingent beneficiaries; modes of premium payments; nonduplication and coordination of benefits; occupational vs. non-occupational; tax treatment of premiums and proceeds; managed care; workers compensation; and subrogation. Section V lists completing the application; explaining sources of insurability and HIPAA privacy information; the initial premium payment and receipt; submitting the application; policy delivery; explaining the policy to clients; replacement; and contract law. [1] This page covers the Hawaii law, Insurance Division and IRS material behind those topics, with 10 practice questions.
Family and dependent coverage
Hawaii defines family coverage as a policy insuring an adult family member, who is the policyholder, and two or more eligible family members, including a spouse, dependent children or children under a specified age that may not exceed nineteen, and any other person dependent on the policyholder. [2]
Age limits and premium
If a policy sets an age limit after which coverage ends, and the insurer accepts premium for a period that runs past that date, coverage continues, subject to any cancellation right, until the end of the period for which premium was accepted. [3]
Protection of benefits
Proceeds of accident and health insurance, and of disability benefits added to life insurance or annuities, are exempt from liability for any debt of the insured, and from any debt of the beneficiary existing when the proceeds become available. [4]
Tax treatment of disability benefits (IRS)
If the employee paid the full cost of disability coverage with after-tax dollars, the benefits are not included in income. If the employer paid part, the part due to the employer's payments is reported as income. Premiums paid through a cafeteria plan and not taxed to the employee are treated as employer paid, so the benefits are taxable. [5]
Managed care and rating terms (Hawaii Insurance Division glossary)
- Primary care provider: a generalist who is your main point of contact and decides whether you need a specialist, hospital or other non-routine care. [6]
- Referral: sending a patient from one practitioner to another; HMOs often require a primary care physician to authorize specialty care. [6]
- Community rating: setting premiums by the average cost of services across all subscribers. [6]
- Experience rating: adjusting premiums based on a group's past use of services. [6]
- Special enrollment period: enrollment outside the open enrollment period after a qualifying life event, such as marriage, a baby or losing coverage. [6]
Practice questions
1. Under Hawaii's family coverage definition, what is the highest specified age a policy may set for covered children?
A. 18
B. 19
C. 21
D. 26
Answer: B. (HRS 431:10A-103) [2]
2. In a Hawaii family policy, who is the policyholder?
Answer: The adult family member insured under the policy. (431:10A-103) [2]
3. A policy's age limit passes, but the insurer accepted premium for the full quarter. When does coverage end?
Answer: At the end of the period for which premium was accepted, subject to any right of cancellation. (HRS 431:10A-114) [3]
4. A creditor of the insured tries to collect from the insured's health insurance proceeds. What is the rule?
Answer: The proceeds are exempt from liability for the insured's debts. (HRS 431:10-231) [4]
5. An employee paid all disability premiums with after-tax money. Are benefits taxable?
Answer: No. [5]
6. Premiums were paid through a cafeteria plan and not taxed to the employee. How are the benefits treated?
Answer: As employer paid, so the benefits are taxable. [5]
7. In an HMO, who usually authorizes specialty care?
Answer: The primary care physician, through a referral. [6]
8. An insurer sets a group's premium based on that group's past use of services. What is that called?
Answer: Experience rating. [6]
9. An insurer sets premiums by the average cost of services across all subscribers. What is that called?
Answer: Community rating. [6]
10. A client has a baby in July. Can she change her individual plan outside open enrollment?
Answer: She may qualify for a special enrollment period, since having a baby is a qualifying life event. [6]
Study tips for sections IV and V
- Family coverage: children under an age no higher than nineteen, plus other dependents.
- Disability taxes follow who paid: after-tax employee premiums mean tax free benefits.
- Rating: community (average of all subscribers) versus experience (this group's history).
- Contract law, replacement and HIPAA privacy information are also in section V. [1]
Practice more with the free Hawaii accident and health practice test.
Prep Retention is independent and is not affiliated with Pearson VUE or the state.
Sources
Laws and exam documents quoted as of October 2026.
- Pearson VUE, Hawaii content outlines 121201 (effective January 1, 2026): https://www.pearsonvue.com/content/dam/VUE/vue/en/documents/publications/121201.pdf
- HRS 431:10A-103: https://data.capitol.hawaii.gov/hrscurrent/Vol09_Ch0431-0435H/HRS0431/HRS_0431-0010A-0103.htm
- HRS 431:10A-114: https://data.capitol.hawaii.gov/hrscurrent/Vol09_Ch0431-0435H/HRS0431/HRS_0431-0010A-0114.htm
- HRS 431:10-231: https://data.capitol.hawaii.gov/hrscurrent/Vol09_Ch0431-0435H/HRS0431/HRS_0431-0010-0231.htm
- IRS, Life Insurance and Disability Insurance Proceeds: https://www.irs.gov/faqs/interest-dividends-other-types-of-income/life-insurance-disability-insurance-proceeds
- Hawaii Insurance Division, Health Insurance Glossary and Terms: https://cca.hawaii.gov/wp-content/uploads/2026/02/Health-Insurance-Glossary-and-Terms.pdf