What the Hawaii Accident & Health Line Covers
Hawaii's health authority is formally the accident and health or sickness line, defined by HRS § 431:9A-107 as "insurance coverage for sickness, bodily injury, or accidental death and benefits for disability income." It covers major medical, disability income, Medicare supplement, long-term care and dental.
It is issued by the DCCA Insurance Division under an Insurance Commissioner appointed by the Director of Commerce and Consumer Affairs with the Governor's approval.
It is a separate line from Life, with a separate exam. Hawaii does not offer a combined Life & Health sitting — a producer who wants both pays $75 twice and sits two exams. The two lines merge only as a single class for continuing-education purposes, which is why a producer holding both still owes just 21 class hours plus 3 ethics rather than a doubled allocation.
No pre-licensing education is required. The handbook states it affirmatively — the Division "does not require a specific program of pre-licensing education, or otherwise pre-screen examination candidates." You study the content outline and book the exam.
What makes this line unusual in Hawaii is not the licensing process but the substantive law behind it. Hawaii's Prepaid Health Care Act has required employer-sponsored coverage since 1974 and holds a unique federal ERISA exemption, which is why no other state has been able to copy it. Between the PHCA, workers' compensation and mandatory Temporary Disability Insurance, Hawaii imposes three separate employer benefit mandates — a market a health producer here has to understand structurally, not just as exam content.
Exam Options & Format
The Hawaii accident and health exam is InsHI_Health02 through Pearson VUE: 85 scored questions plus 10 unscored pretest items, at $75, passing at a scaled 70.
As with every Hawaii producer exam it arrives in two separately-timed sections: a general-knowledge section of 50 scored questions in 75 minutes and a Hawaii-specific section of 35 scored questions in 45 minutes. Time does not carry across the boundary.
Only failing candidates receive a number. The handbook: "numeric scores are only reported to failing candidates." A pass is reported as a pass. And the 70 is a scaled score rather than a raw percentage — so "I need 70% right" is not quite what the standard says.
Both the Life and Accident & Health exams are the same length and price, which makes the decision about pursuing both a question of study time rather than fees. The Life guide covers that exam and the application path that follows either one.
You can sit this exam at a test center or through OnVUE — and that choice has consequences beyond convenience, which the next section sets out.
Most Tested Topics on the Hawaii Accident & Health Exam
Hawaii's health law diverges from the national baseline more sharply than any other state's, because of one 1974 statute that everywhere else would have been preempted. Each row is verified:
| Concept | The Hawaii rule |
|---|---|
| Employer mandate | The Prepaid Health Care Act (HRS ch. 393) — the only state employer health mandate with a federal ERISA exemption, in force since 1974 |
| PHCA hours threshold | 20 hours per week for a "regular employee" — well below the ACA's 30-hour full-time definition (§ 393-3) |
| PHCA wage test | Also required: monthly wages of at least 86.67 times the minimum hourly wage — $1,387.00 for 2026 (§ 393-11) |
| Employee contribution cap | "In no case shall the employee contribute more than 1.5 per cent of the employee's wages" (§ 393-13) |
| Employer share | At least one-half of the premium — and where the employee's 1.5%-capped share falls short of half, the employer pays the entire balance |
| Who administers it | DLIR, the Department of Labor and Industrial Relations — not the Insurance Division |
| Health insurance marketplace | Federal — HealthCare.gov. Hawaii's own Hawaii Health Connector failed and closed |
| Medicaid | Expanded — Med-QUEST / QUEST Integration, adults at 133% FPL (138% with the 5% disregard) |
| Prompt pay, electronic | 15 calendar days to pay an uncontested claim (§ 431:13-108) |
| Prompt pay, paper | 30 calendar days |
| Notice to contest or deny | 7 days electronic, 15 days written |
| Late-payment interest | 15% per year, and accrued interest of $2 or more is added automatically |
| External review | Requests go in writing to the Insurance Commissioner, who assigns an approved Independent Review Organization; the decision binds the carrier (HRS ch. 432E) |
| State continuation | Hawaii has no general private-sector mini-COBRA — federal COBRA governs. The PHCA instead keeps the employer paying its premium share for up to 3 months while an employee is disabled (§ 393-15) |
The Prepaid Health Care Act is the highest-yield subject on this exam, and the trap is the threshold. A candidate who has studied the ACA arrives with 30 hours a week in mind. Hawaii's figure is 20 — plus the monthly wage test — which means Hawaii employers must cover a broader population than federal law requires. Pair the 20 hours with the 1.5% employee contribution cap and the employer's at-least-half obligation, and you have the three numbers most questions are built from.
The second point is what Hawaii lacks: there is no general state continuation statute. Most states have a mini-COBRA filling the gap below the federal 20-employee threshold; Hawaii does not, because near-universal employer coverage under the PHCA made one largely unnecessary. What exists instead is the PHCA's own 3-month employer-paid continuation during disability — a narrower and differently-shaped protection, and one that questions like to contrast with COBRA.
Testing from Home with OnVUE — and the Retake Trap
Hawaii is one of the states where online proctored testing is genuinely live. The Insurance Division authorized it effective 18 May 2021, describing "Pearson's online proctoring process in addition to the standard test center process," and both the Division's current exam page and the January 2026 handbook still list it. In an archipelago this matters more than it would anywhere else: it is the difference between a flight and a morning at your desk.
But read the retake rules before you choose it, because they are not symmetrical. At a test center, a failed candidate must wait 24 hours before booking again. Through OnVUE, the first retest cannot be taken for 2 weeks, and every subsequent retest for 4 weeks.
Think about what that means in practice. A Kauai candidate has no test center on their island — the current handbook lists Honolulu and Haleiwa on Oahu, Kahului on Maui and Hilo on Hawaii Island, and no Kauai or Kona site. OnVUE looks like the obvious answer, and often is. But a candidate who fails online is locked out for a fortnight, where an Oahu candidate is back in a chair the next morning. If you are on a deadline — a start date, or the two-year exam clock — the flight may buy back more time than it costs.
What OnVUE requires of your setup. Windows 10 or macOS 14 or higher; a stable connection of at least 6 Mbps down and 2 Mbps up; a webcam and microphone; and a completely cleared desk and workspace. Run Pearson VUE's system test before exam day rather than on it — an environment failure at check-in burns the appointment.
What the proctor will require of your room. You will photograph your workspace from several angles at check-in. No second monitor, no phone within reach, no notes, no drinks, nobody else in the room, and no talking aloud. The proctor watches and listens throughout.
Check in 30 minutes early. The check-in process — ID capture, room scan, proctor handoff — takes real time, and it is not deducted from your exam clock but it can cost you the appointment if you start it late.
Bring the same ID you would to a center. Government-issued, photo-bearing, unexpired, and matching your registration name exactly. Pearson VUE "does not recognize grace periods" on expired identification, and that rule is applied identically online.
And know the one comfort you give up: there are no breaks. Breaks are not permitted during an OnVUE exam. For this two-hour, two-section sitting that means planning accordingly before you start — because standing up mid-exam ends it.
A reasonable rule of thumb. If you live on Oahu, Maui or in Hilo, test at a center: the 24-hour retake window is worth more than the commute. If you are on Kauai, Molokai, Lanai or the Kona side, OnVUE is usually right — but prepare as though you get one attempt, because functionally, for the next fortnight, you do.
What It Costs
$75 to Pearson VUE for InsHI_Health02, and $150 to the Insurance Division for the resident producer licence through NIPR — $225 in published fees on a first-attempt pass, plus Fieldprint's fingerprint charge, which the Division does not publish.
There is no course to buy. Hawaii requires zero pre-licensing hours, which removes what is usually the biggest number in this budget.
If you want the Life line too, budget a second $75. Hawaii has no combined exam, so both lines means both sittings. One economy is available: file both applications simultaneously and a single fingerprinting covers them. File them months apart and you pay Fieldprint twice.
Recurring: $100 to renew every two years, $300 to reapply within a year of nonrenewal. CE is 24 hours per cycle whether you hold one line or both.
Eligibility Requirements
You must be at least 18, pass InsHI_Health02, complete fingerprinting through Fieldprint under code HI-DCCA-INS, and file through NIPR within 60 days of being fingerprinted with the $150 fee. The Casualty guide walks the fingerprint process in detail.
No professional designation waives a Hawaii exam. HRS § 431:9A-109 names none — the only statutory exemption is prior licensure for the same lines in another state, either current or cancelled within the past 90 days in good standing. A producer moving to Hawaii must apply within 90 days of establishing legal residence to use it.
Your passing score is good for two years, measured backward from license issuance under HRS § 431:9A-106 — not from your application date. The Life guide covers the application step by step; the P&C guide covers reciprocity and nonresident licensing.
Keeping Your License Active
Important CE details: Life and accident & health count as ONE class for CE purposes, so a producer holding both owes 21 class hours plus 3 ethics, not two separate allocations.
24 credit hours every two years, due by the last day of your birth month — though in practice 15 days before it, because Commissioner's Memorandum 2022-3LIC requires completion that far ahead to allow providers their 15 days to report.
Holding accident and health alone, or together with life, the split is 21 hours in the life/accident-and-health class plus 3 hours of ethics or Hawaii insurance laws and rules. Add a property or casualty line and the split changes to 10 + 11 + 3 — the P&C guide covers that configuration.
No carryover. Excess hours do not roll forward, so there is nothing to gain by banking them.
Miss the deadline and the licence goes inactive automatically. Reinstatement within twelve months costs $300 — the $100 renewal plus a penalty of double that — and does not require retaking the exam. Adding a line mid-cycle does not extend your cycle: the full 24 hours, including hours for the new line, are still due by your existing renewal date.
Quick Reference
Official Links
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