Hawaii health insurance law practice questions
Last updated
The Hawaii part of the Accident and Health exam has 35 scored questions, and section II, Hawaii laws and rules pertinent to accident and health insurance only, accounts for 12 of them. [1] It covers the prepaid health care law (HRS chapter 393), temporary disability insurance (HRS chapter 392), mandated benefits, the cancellation provision, and long term care. [1] This page covers everything except long term care, with 12 practice questions.
Hawaii Prepaid Health Care Act (HRS chapter 393)
- Who must be covered: a regular employee is someone employed by one employer for at least twenty hours a week, not counting seasonal work. [2] An employer who pays a regular employee monthly wages of at least 86.67 times the minimum hourly wage must provide coverage under a qualifying prepaid group health care plan. [3]
- When coverage starts: after the employee has worked four consecutive weeks, at the earliest time the plan contractor can provide coverage. [4]
- Who pays: unless a collective bargaining agreement says otherwise, the employer pays at least half the premium, and the employee's share may not be more than 1.5 per cent of the employee's wages. [5]
- Required benefits: a qualifying plan includes at least 120 days of inpatient hospital care each calendar year, surgical and medical benefits, diagnostic services, and maternity benefits at least if the employee was covered for nine consecutive months before delivery. [6]
- Penalty: an employer who fails to comply with the coverage, plan or premium sections pays at least $25, or $1 for each employee for each day the failure continues, whichever is greater. [7]
Temporary Disability Insurance (HRS chapter 392)
- What it covers: disability from sickness, accident, pregnancy, termination of pregnancy or organ donation that is not work connected. [8]
- Eligibility: at least fourteen weeks of employment in the 52 weeks before the disability, each with twenty or more hours of work, and at least $400 in wages. [9]
- Waiting period: no benefits for the first seven consecutive days of disability. [9]
- Amount and length: fifty eight per cent of average weekly wage when that wage is $26 or more, subject to a maximum, for no more than twenty six weeks in any period of disability or benefit year. [10] [9]
- Employee cost: an employer may withhold one half of the cost, but not more than 0.5 per cent of weekly wages. [11]
- Claims: the first payment is due within ten days, not counting weekends and holidays, after proof of claim is filed, then every two weeks. [12]
Mandated benefits (HRS 431:10 and 431:10A)
- Newborns: family coverage on an expense incurred basis must cover a newborn from the moment of birth for congenital defects and birth abnormalities. If a premium is required, the insurer may require notice and payment within thirty one days of birth for coverage to continue. [13]
- Child health supervision: policies covering children must cover twelve visits from birth through age five, with no deductible, and immunizations free of copayments. [14]
- Mammograms: an annual mammogram for women forty and older, and for a woman of any age with a personal or mother's or sister's history of breast cancer, on her physician's recommendation. [15] No referral may be required for the annual screening at forty and older. [16]
- Disabled children: coverage of a child unable to support themselves because of intellectual disability or physical handicap does not end at the limiting age, if proof is given within thirty one days of reaching that age. [17]
- Domestic abuse: an insurer may not refuse, cancel or charge more because someone is or may be a victim of domestic abuse. [18]
- Group and blanket policies: must cover newborns the same way and give the same specific service coverages. [19]
- Child support orders: an employer that covers employees' children must recognize a child named in a qualified medical child support order as an eligible dependent without regard to enrollment season restrictions. [20]
Cancellation (HRS 431:10A-106(7))
If used, the provision lets the insurer cancel with written notice effective not less than five days later. If the insured cancels, earned premium uses the short rate table; if the insurer cancels, earned premium is pro rata. Cancellation does not affect a claim that began before the cancellation date. [21]
Practice questions
1. How many hours a week must someone work for one employer to be a regular employee under the Prepaid Health Care Act?
A. 10
B. 20
C. 30
D. 40
Answer: B. (HRS 393-3) [2]
2. When must coverage begin for a new regular employee?
Answer: After four consecutive weeks of employment, at the earliest time the contractor can provide it. (HRS 393-14) [4]
3. What is the most an employee can be required to contribute toward prepaid health care coverage?
Answer: 1.5 per cent of wages, with the employer paying at least half the premium. (HRS 393-13) [5]
4. How many days of inpatient hospital care must a qualifying prepaid plan provide each calendar year?
Answer: At least 120 days. (HRS 393-7(c)(1)) [6]
5. A worker hurts her back at home. Which Hawaii law provides partial wage replacement?
Answer: Temporary Disability Insurance (HRS chapter 392), because the injury is not work connected. [8]
6. How long is the TDI waiting period?
Answer: The first seven consecutive days of disability. (HRS 392-24) [9]
7. What is the longest TDI benefits can be paid for one period of disability?
Answer: Twenty six weeks. (HRS 392-23) [9]
8. A worker's average weekly wage is $900. What share of it is the TDI weekly benefit, before the maximum applies?
Answer: Fifty eight per cent, rounded up to the next whole dollar and subject to the maximum weekly benefit. This rate applies when the average weekly wage is $26 or more. (HRS 392-22) [10]
9. A family policy requires an added premium for a newborn. How long does the parent have to give notice and pay?
Answer: Thirty one days after the birth. (HRS 431:10A-115) [13]
10. Must a 45 year old woman get a referral for her annual screening mammogram?
Answer: No. (HRS 431:10A-116.2) [16]
11. Can an insurer refuse to renew a policy because the insured is a victim of domestic abuse?
Answer: No. (HRS 431:10-217.5) [18]
12. The insurer cancels a policy under the cancellation provision. How is the earned premium figured?
Answer: Pro rata. (HRS 431:10A-106(7)) [21]
Study tips
- Prepaid health care numbers: 20 hours, 4 weeks, 1.5 per cent, half the premium, 120 days.
- TDI numbers: 14 weeks, 20 hours, $400, 7 day wait, 58 per cent, 26 weeks.
- For mandates, know who is covered and the time limits: 31 days for newborn premium notice, 31 days for proof of a disabled child.
Practice more with the Hawaii accident and health practice test or the Hawaii insurance law 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 393-3: https://data.capitol.hawaii.gov/hrscurrent/Vol07_Ch0346-0398/HRS0393/HRS_0393-0003.htm
- HRS 393-11: https://data.capitol.hawaii.gov/hrscurrent/Vol07_Ch0346-0398/HRS0393/HRS_0393-0011.htm
- HRS 393-14 and 393-15: https://data.capitol.hawaii.gov/hrscurrent/Vol07_Ch0346-0398/HRS0393/HRS_0393-0014.htm and https://data.capitol.hawaii.gov/hrscurrent/Vol07_Ch0346-0398/HRS0393/HRS_0393-0015.htm
- HRS 393-13: https://data.capitol.hawaii.gov/hrscurrent/Vol07_Ch0346-0398/HRS0393/HRS_0393-0013.htm
- HRS 393-7: https://data.capitol.hawaii.gov/hrscurrent/Vol07_Ch0346-0398/HRS0393/HRS_0393-0007.htm
- HRS 393-33: https://data.capitol.hawaii.gov/hrscurrent/Vol07_Ch0346-0398/HRS0393/HRS_0393-0033.htm
- HRS 392-3 and 392-21: https://data.capitol.hawaii.gov/hrscurrent/Vol07_Ch0346-0398/HRS0392/HRS_0392-0003.htm and https://data.capitol.hawaii.gov/hrscurrent/Vol07_Ch0346-0398/HRS0392/HRS_0392-0021.htm
- HRS 392-23, 392-24 and 392-25: https://data.capitol.hawaii.gov/hrscurrent/Vol07_Ch0346-0398/HRS0392/HRS_0392-0023.htm, https://data.capitol.hawaii.gov/hrscurrent/Vol07_Ch0346-0398/HRS0392/HRS_0392-0024.htm and https://data.capitol.hawaii.gov/hrscurrent/Vol07_Ch0346-0398/HRS0392/HRS_0392-0025.htm
- HRS 392-22: https://data.capitol.hawaii.gov/hrscurrent/Vol07_Ch0346-0398/HRS0392/HRS_0392-0022.htm
- HRS 392-43: https://data.capitol.hawaii.gov/hrscurrent/Vol07_Ch0346-0398/HRS0392/HRS_0392-0043.htm
- HRS 392-44: https://data.capitol.hawaii.gov/hrscurrent/Vol07_Ch0346-0398/HRS0392/HRS_0392-0044.htm
- HRS 431:10A-115: https://data.capitol.hawaii.gov/hrscurrent/Vol09_Ch0431-0435H/HRS0431/HRS_0431-0010A-0115.htm
- HRS 431:10A-115.5: https://data.capitol.hawaii.gov/hrscurrent/Vol09_Ch0431-0435H/HRS0431/HRS_0431-0010A-0115_0005.htm
- HRS 431:10A-116: https://data.capitol.hawaii.gov/hrscurrent/Vol09_Ch0431-0435H/HRS0431/HRS_0431-0010A-0116.htm
- HRS 431:10A-116.2: https://data.capitol.hawaii.gov/hrscurrent/Vol09_Ch0431-0435H/HRS0431/HRS_0431-0010A-0116_0002.htm
- HRS 431:10-212: https://data.capitol.hawaii.gov/hrscurrent/Vol09_Ch0431-0435H/HRS0431/HRS_0431-0010-0212.htm
- HRS 431:10-217.5: https://data.capitol.hawaii.gov/hrscurrent/Vol09_Ch0431-0435H/HRS0431/HRS_0431-0010-0217_0005.htm
- HRS 431:10A-206 and 431:10A-207: https://data.capitol.hawaii.gov/hrscurrent/Vol09_Ch0431-0435H/HRS0431/HRS_0431-0010A-0206.htm and https://data.capitol.hawaii.gov/hrscurrent/Vol09_Ch0431-0435H/HRS0431/HRS_0431-0010A-0207.htm
- HRS 431:10A-208: https://data.capitol.hawaii.gov/hrscurrent/Vol09_Ch0431-0435H/HRS0431/HRS_0431-0010A-0208.htm
- HRS 431:10A-106: https://data.capitol.hawaii.gov/hrscurrent/Vol09_Ch0431-0435H/HRS0431/HRS_0431-0010A-0106.htm