Hawaii Prepaid Health Care Act: exam guide and practice questions
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The Hawaii part of the Accident and Health exam lists prepaid health care, HRS chapter 393, as the first item under marketing methods and practices in section II, Hawaii laws and rules pertinent to accident and health insurance only. That section has 12 of the 35 Hawaii questions. [1] Our Hawaii health law questions page covers the twenty hour test, the four week start, cost sharing and required benefits. This page covers the rest of the law, with 10 practice questions.
Purpose (HRS 393-1, 393-2)
The chapter is the "Hawaii Prepaid Health Care Act." The Legislature found that the cost of medical care in a sudden need may consume all or an excessive part of a person's resources, and that prepaid health care plans offer a measure of protection. The chapter's purpose is to give employees in the State this type of protection. It does not reduce more favorable or equivalent protection already provided under collective bargaining agreements or employer-sponsored plans. [2]
Which work counts (HRS 393-5, 393-6)
Employment does not include, among other listed services, service for a spouse, son or daughter, or service by someone under twenty one for a father or mother. [3] If a person is a regular employee of two or more employers at once, the principal employer is the one that pays the most wages, with an exception described in the law. [4] An employer notified by the employee that it is not the principal employer does not have to provide coverage until notified that it has become the principal employer. [5]
Exemptions and waivers
- Employee exemptions (HRS 393-17): an employer is relieved of the coverage duty for an employee who gives notice that they are protected by health insurance or a prepaid health care plan established under federal law, covered as a dependent under a qualifying plan, or receiving public assistance or covered under the State's medical assistance plan. [6]
- Ending an exemption (HRS 393-18): if the employee's exemption ends because circumstances change, the employee must promptly tell the principal employer, which must then provide coverage. [7]
- Individual waiver (HRS 393-21): an employee may waive all required benefits by written request to the employer and approval by the director, who must find the employee has other qualifying coverage. A waiver lasts one year and may be renewed. Coercing a waiver is penalized. [8]
- Religious exemption (HRS 393-22): the chapter does not apply to anyone who, by the teachings of their group, depends for healing on prayer or other spiritual means. [9]
Employer choices and enforcement
- Type of plan (HRS 393-12): the employer chooses a plan that furnishes care or one that pays or reimburses the cost of care, and the choice is binding for one year. [10]
- Joint coverage (HRS 393-23): employers may form associations to provide prepaid health care jointly. [11]
- Liability (HRS 393-24): an employer that fails to provide required coverage must pay the health care costs an eligible employee incurs during the gap. [12]
- Penalties (HRS 393-33, 393-34): an employer that fails to begin compliance for thirty days may be enjoined from doing business in the State while the default continues. Violations with no other stated penalty can bring a fine of up to $250 per offense after twenty one days' written notice and a chance to be heard. [13] [14]
- Premium supplementation (HRS 393-41): the chapter creates a trust fund for premium supplementation. [15]
Practice questions
1. What does the Prepaid Health Care Act aim to protect employees from?
A. Lost wages from disability
B. Medical costs that could consume all or an excessive part of their resources
C. Work injuries
D. Unemployment
Answer: B. (HRS 393-2) [2]
2. A 17 year old works in his mother's shop. Is that employment under the Act?
Answer: No. Service by someone under twenty one for a father or mother is excluded. (HRS 393-5(2)) [3]
3. An employee works regular hours for two employers. Which one is generally the principal employer?
Answer: The one that pays the most wages, with an exception in the law. (HRS 393-6) [4]
4. An employee is already covered as a dependent under a spouse's qualifying plan and gives notice. What must the employer do?
Answer: Nothing for that employee while the exemption applies. The employer is relieved of the coverage duty. (HRS 393-17(a)(2)) [6]
5. How long does an approved individual waiver last?
Answer: One year, renewable for later one-year periods. (HRS 393-21(c)) [8]
6. Who must approve an individual waiver?
Answer: The director, after finding the employee has other qualifying coverage. (393-21(a)) [8]
7. Does the Act apply to someone who relies on prayer for healing under their group's teachings?
Answer: No. (HRS 393-22) [9]
8. How long is an employer's choice of plan type binding?
Answer: One year. (HRS 393-12(a)) [10]
9. An employer never provided required coverage, and an employee runs up medical bills. Who pays?
Answer: The employer is liable for those health care costs. (HRS 393-24) [12]
10. An employer has not begun complying for thirty days. What can a court do?
Answer: Enjoin the employer from carrying on business in the State while the default continues. (HRS 393-33(c)) [13]
Study tips
- The Act protects against medical costs; TDI protects against lost wages.
- Exemptions come from the employee's notice; waivers need the director's approval and last one year.
- One year also applies to the employer's choice of plan type.
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 393-1 and 393-2: https://data.capitol.hawaii.gov/hrscurrent/Vol07_Ch0346-0398/HRS0393/HRS_0393-0001.htm and https://data.capitol.hawaii.gov/hrscurrent/Vol07_Ch0346-0398/HRS0393/HRS_0393-0002.htm
- HRS 393-5: https://data.capitol.hawaii.gov/hrscurrent/Vol07_Ch0346-0398/HRS0393/HRS_0393-0005.htm
- HRS 393-6: https://data.capitol.hawaii.gov/hrscurrent/Vol07_Ch0346-0398/HRS0393/HRS_0393-0006.htm
- HRS 393-16: https://data.capitol.hawaii.gov/hrscurrent/Vol07_Ch0346-0398/HRS0393/HRS_0393-0016.htm
- HRS 393-17: https://data.capitol.hawaii.gov/hrscurrent/Vol07_Ch0346-0398/HRS0393/HRS_0393-0017.htm
- HRS 393-18: https://data.capitol.hawaii.gov/hrscurrent/Vol07_Ch0346-0398/HRS0393/HRS_0393-0018.htm
- HRS 393-21: https://data.capitol.hawaii.gov/hrscurrent/Vol07_Ch0346-0398/HRS0393/HRS_0393-0021.htm
- HRS 393-22: https://data.capitol.hawaii.gov/hrscurrent/Vol07_Ch0346-0398/HRS0393/HRS_0393-0022.htm
- HRS 393-12: https://data.capitol.hawaii.gov/hrscurrent/Vol07_Ch0346-0398/HRS0393/HRS_0393-0012.htm
- HRS 393-23: https://data.capitol.hawaii.gov/hrscurrent/Vol07_Ch0346-0398/HRS0393/HRS_0393-0023.htm
- HRS 393-24: https://data.capitol.hawaii.gov/hrscurrent/Vol07_Ch0346-0398/HRS0393/HRS_0393-0024.htm
- HRS 393-33: https://data.capitol.hawaii.gov/hrscurrent/Vol07_Ch0346-0398/HRS0393/HRS_0393-0033.htm
- HRS 393-34: https://data.capitol.hawaii.gov/hrscurrent/Vol07_Ch0346-0398/HRS0393/HRS_0393-0034.htm
- HRS 393-41: https://data.capitol.hawaii.gov/hrscurrent/Vol07_Ch0346-0398/HRS0393/HRS_0393-0041.htm