HS 311 study guide
HS 311 · Work through your exam, one topic at a time.
HS 311 is a state health insurance licensing exam line covering the knowledge a producer needs to sell, explain, and service health and related coverage. It is intended for candidates entering the individual and group health market, agency staff who support licensed producers, and career changers moving into benefits or senior-market work. The HS 311 study guide has 9 sections and about 3,659 words.
01Foundations of Health Insurance
Domain 1 tests whether you can explain why health insurance exists and how its cost-sharing pieces interact - not product details, which come later. Expect questions on risk classification, insurable interest, adverse selection, and arithmetic that combines deductibles, coinsurance, copayments, and out-of-pocket maximums.
385 words, about 2 min02Health Insurance Providers and the Marketplace
Domain 2 covers who sells and delivers coverage and how the ACA Marketplaces operate. Questions mix carrier structure with Marketplace eligibility and subsidy arithmetic.
422 words, about 2 min03Medical Expense Insurance
Medical expense insurance pays for treatment of sickness or injury. Domain 3 tests how benefits are structured, how limits apply, and how network status changes what the patient owes.
379 words, about 2 min04Disability Income Insurance
Domain 4 tests income replacement: definitions of disability, timing, benefit calculation, offsets, and renewability. Benefit amount is a percentage of pre-disability income, typically 60–70%; insurers cap total benefits so they plus other income do not exceed a set share of income, preserving the incentive to return to work.
382 words, about 2 min05Accident and Sickness Insurance
Domain 5 covers policies whose trigger is a specific event - an accident or a named sickness - rather than all medical care. The exam tests definitions, benefit schedules, and how these products differ from major medical.
402 words, about 2 min06Long-Term Care Insurance
Domain 6 tests long-term care: what triggers benefits, which levels of care are covered, and how policy features control cost. A tax-qualified policy pays when a licensed health care practitioner certifies either (1) inability to perform at least 2 of the 6 activities of daily living - bathing, dressing, toileting, transferring, eating, continence - expected to last at least 90 days, or (2) a severe cognitive impairment (such as Alzheimer's disease) requiring substantial supervision.
412 words, about 2 min07Medicare and Medicaid
Domain 7 tests the federal/state split: Medicare is federally funded and based on age or disability; Medicaid is jointly funded and income-based. Part A (hospital insurance): inpatient hospital, skilled nursing facility after a qualifying stay, hospice, and some home health.
408 words, about 2 min08Group Health Insurance
Domain 8 tests employer-sponsored coverage: eligibility rules, COBRA continuation, coordination of benefits, and the distinction between insured and self-funded plans. Underwriting focuses on the group, not the individual: group size, industry, age and gender mix, prior claims, and participation.
401 words, about 2 min09Health Insurance Policy Provisions and Regulation
Domain 9 tests the standard provisions found in every health policy and the regulatory framework behind them. Expect questions on time limits and on who may do what.
468 words, about 2 min