NORTH CAROLINA HEALTH INSURANCE
STATE 2026 ACTUAL TEST PAPER
ANSWERS COMPLETE GRADED A+
⩥ While repairing the roof of his house an insured accidentally falls off
and breaks his arm and sustains a head injury that results in total
blindness of both eyes. His policy contains an Accidental Death &
Dismemberment Rider. What is the extent of benefits that he will
receive?
A. Reciprocal Amount
B. Principal Sum
C. Capital Sum
D. 50% of the Principal.
Answer: B.
⩥ Which of the following is true regarding inpatient hospital care for
HMO members?
A. Inpatient hospital care is not part of HMO services
B. Care can be provided outside of the service area
C. Can can only be provided in the service area
D. Services for treatment of mental disorders are unlimited.
Answer: B.
,⩥ As it pertains to group health insurance, the continuation provision
stipulates that
A. Terminated employees may convert to an individual policy only upon
proof of insurability
B. Group coverage must be extended for terminated employees up to a
certain period of time at the employers expense
C. Group coverage must be extended for terminated employees up to a
certain period of time at the employees expense
D. Retiring employees must be allowed to convert their group coverage
to individual policies.
Answer: C.
⩥ All of the following apply to short term disability plans EXCEPT
A. Individual plans can provide benefit periods of up to 2 years
B. A benefit period of 26 weeks is most common for group plans
C. Both group and individual plans are renewable
D. Group plans can provide benefit periods of up to 52 weeks.
Answer: C.
⩥ Which describes the features of a comprehensive major medical
policy?
A. There is no coinsurance
B. Basic medical expense benefits are provided in single package
C. The deductible is always expressed as a deferred amount
,D. It is the same as major medical insurance.
Answer: B.
⩥ If an insurer accepts premium payments by credit card, who is
responsible for paying the fees charged by a credit card company?
A. Credit card company
B. Insurer accepting payment
C. Policy owners, as part of premium
D. Insured.
Answer: B.
⩥ When a disabled dependent child reaches the age limit for coverage,
how long does the policyowner have to provide proof of dependency in
order for the dependent to remain covered under the policy?
A. 15 days
B. 31 days
C. 60 days
D. 10 days.
Answer: B.
⩥ If a licensee is convicted of a criminal violation , the licensees
insurance license is?
A. Suspended after hearing
, B. Automatically suspended
C. Automatically revoked
D. Not affected.
Answer: B.
⩥ All of the following are differences between Individual and group
health insurance EXCEPT
A. In individual policies, the individual selects coverage options, while
in a group plan all employees are covered for the same coverage which
is chosen by employer
B. Individual coverage can be written on an occupation or no
occupational basis
C. Individual policies are renewable, while group terminates when the
individual leaves
D. Individual insurance does not require medical examinations, while
group insurance does not require medical examinations.
Answer: D.
⩥ A licensee decides to terminate his residency in the state. Which of the
following would be an appropriate action?
A. Delivering the license to the commissioner within 30 days
B. Allowing the license to expire
C. Notifying the NAIC
D. Notifying the commissioner within 10 days.
STATE 2026 ACTUAL TEST PAPER
ANSWERS COMPLETE GRADED A+
⩥ While repairing the roof of his house an insured accidentally falls off
and breaks his arm and sustains a head injury that results in total
blindness of both eyes. His policy contains an Accidental Death &
Dismemberment Rider. What is the extent of benefits that he will
receive?
A. Reciprocal Amount
B. Principal Sum
C. Capital Sum
D. 50% of the Principal.
Answer: B.
⩥ Which of the following is true regarding inpatient hospital care for
HMO members?
A. Inpatient hospital care is not part of HMO services
B. Care can be provided outside of the service area
C. Can can only be provided in the service area
D. Services for treatment of mental disorders are unlimited.
Answer: B.
,⩥ As it pertains to group health insurance, the continuation provision
stipulates that
A. Terminated employees may convert to an individual policy only upon
proof of insurability
B. Group coverage must be extended for terminated employees up to a
certain period of time at the employers expense
C. Group coverage must be extended for terminated employees up to a
certain period of time at the employees expense
D. Retiring employees must be allowed to convert their group coverage
to individual policies.
Answer: C.
⩥ All of the following apply to short term disability plans EXCEPT
A. Individual plans can provide benefit periods of up to 2 years
B. A benefit period of 26 weeks is most common for group plans
C. Both group and individual plans are renewable
D. Group plans can provide benefit periods of up to 52 weeks.
Answer: C.
⩥ Which describes the features of a comprehensive major medical
policy?
A. There is no coinsurance
B. Basic medical expense benefits are provided in single package
C. The deductible is always expressed as a deferred amount
,D. It is the same as major medical insurance.
Answer: B.
⩥ If an insurer accepts premium payments by credit card, who is
responsible for paying the fees charged by a credit card company?
A. Credit card company
B. Insurer accepting payment
C. Policy owners, as part of premium
D. Insured.
Answer: B.
⩥ When a disabled dependent child reaches the age limit for coverage,
how long does the policyowner have to provide proof of dependency in
order for the dependent to remain covered under the policy?
A. 15 days
B. 31 days
C. 60 days
D. 10 days.
Answer: B.
⩥ If a licensee is convicted of a criminal violation , the licensees
insurance license is?
A. Suspended after hearing
, B. Automatically suspended
C. Automatically revoked
D. Not affected.
Answer: B.
⩥ All of the following are differences between Individual and group
health insurance EXCEPT
A. In individual policies, the individual selects coverage options, while
in a group plan all employees are covered for the same coverage which
is chosen by employer
B. Individual coverage can be written on an occupation or no
occupational basis
C. Individual policies are renewable, while group terminates when the
individual leaves
D. Individual insurance does not require medical examinations, while
group insurance does not require medical examinations.
Answer: D.
⩥ A licensee decides to terminate his residency in the state. Which of the
following would be an appropriate action?
A. Delivering the license to the commissioner within 30 days
B. Allowing the license to expire
C. Notifying the NAIC
D. Notifying the commissioner within 10 days.
