NJ Accident and Health Producer Exam Updated
Actual Question and Answer (2026/2027) | A+
Verified
• What does coinsurance mean?
- a policy covers the insured and the any additional named persons
-the insurer and the insured share expenses over the deductible
-the insurer and the insured share ALL expenses
-the policy owner holds multiple policies through the same insurer -✓✓ The
insurer and the insured share expenses over the deductible
COINSURANCE IS THE SHARING BETWEEN THE INSURER AND THE
INSURED OF COVERED EXPENSES THAT EXCEED THE DEDUCTIBLE
AMOUNT. THE SHARING ENDS WHEN THE "STOP LOSS LIMIT" IS
REACHED
• The life insurance policy will not be truly effect until all of the following occur
EXCEPT:
-the statement of good health is obtained by the insurer
-the first premium is collected
-the policy is delivered to the applicant
-the producer has explained the policy to the client -✓✓ -the producer has
explained the policy to the client
EFFECTIVE DATE BASED ON :
-APP DATE
-IF PREMIUM HAS BEEN PAID
,-IF A STATEMENT OF GOOD HEALTH MUST BE OBTAINED IF PREMIUM
WAS NOT SUBMITTED WITH APPLICATION
• Which of the following coverage types pays a monthly cash benefit following the
elimination period for total disability due to accident or sickness?
-credit disability
-works comp disability
-recurrent disability
-disability income -✓✓ -disability income insurance
PROVIDES PAYMENT OF REGULAR PERIODIC INCOME SHOULD THE
INSURED BECOME DISABLED FROM ILLNESS OR INJURY
• The period beginning at the time of an insured loss that an insured must wait
before benefits are payable is called the:
-probationary period
-benefit period
-elimination period
-grace period -✓✓ -elimination period
THE TIME PERIOD STARTING AT THE TIME OF LOSS, SUCH AS A
DISABILITY, THAT AN INSURED MUST WAIT BEFORE BENEFITS ARE
PAYABLE
• Managed care plans increase efficiency by all of the following EXCEPT:
-transferring the management of costs to the insureds
-controlling inpatient admissions and length of stay
, -increasing beneficiary cost sharing
-selectively contracting with health care providers -✓✓ -transferring the
management of costs to the insureds
MANAGED CARE PLANS ARE DESIGNED TO USE COST SAVING
SERVICES BY USING CLOSED NETWORKS AND MANAGING HEALTH
CARE WITH THESE NETWORKS
• Under an individual policy, and insured who CANNOT perform the duties of
his/her own occupation for a specific period of time is:
-totally disabled
-permanently disabled
-residually disabled
-occupationally disabled -✓✓ -totally disabled
TOTAL DISABILITY IS DEFINED AS THE INABILITY OF INSURED TO
PERFORM ALL THE DUTIES OF HIS REGULAR OCCUPATION FOR THE
FIRST 24 MONTHS AFTER A LOSS
• How do most disability policies handle the case of a recurrent disability occurring
at least 90 days after the first claim?
-it is excluded from coverage because benefits have already been paid
-it must be handled as a new claim for a new period of disability
-it is handled as a continuation of the existing claim
-it must be handled as new claim for a new period of disability, requiring a new
elimination period -✓✓ -it must be handled as a new claim for a new period of
disability, requiring a new elimination period
Actual Question and Answer (2026/2027) | A+
Verified
• What does coinsurance mean?
- a policy covers the insured and the any additional named persons
-the insurer and the insured share expenses over the deductible
-the insurer and the insured share ALL expenses
-the policy owner holds multiple policies through the same insurer -✓✓ The
insurer and the insured share expenses over the deductible
COINSURANCE IS THE SHARING BETWEEN THE INSURER AND THE
INSURED OF COVERED EXPENSES THAT EXCEED THE DEDUCTIBLE
AMOUNT. THE SHARING ENDS WHEN THE "STOP LOSS LIMIT" IS
REACHED
• The life insurance policy will not be truly effect until all of the following occur
EXCEPT:
-the statement of good health is obtained by the insurer
-the first premium is collected
-the policy is delivered to the applicant
-the producer has explained the policy to the client -✓✓ -the producer has
explained the policy to the client
EFFECTIVE DATE BASED ON :
-APP DATE
-IF PREMIUM HAS BEEN PAID
,-IF A STATEMENT OF GOOD HEALTH MUST BE OBTAINED IF PREMIUM
WAS NOT SUBMITTED WITH APPLICATION
• Which of the following coverage types pays a monthly cash benefit following the
elimination period for total disability due to accident or sickness?
-credit disability
-works comp disability
-recurrent disability
-disability income -✓✓ -disability income insurance
PROVIDES PAYMENT OF REGULAR PERIODIC INCOME SHOULD THE
INSURED BECOME DISABLED FROM ILLNESS OR INJURY
• The period beginning at the time of an insured loss that an insured must wait
before benefits are payable is called the:
-probationary period
-benefit period
-elimination period
-grace period -✓✓ -elimination period
THE TIME PERIOD STARTING AT THE TIME OF LOSS, SUCH AS A
DISABILITY, THAT AN INSURED MUST WAIT BEFORE BENEFITS ARE
PAYABLE
• Managed care plans increase efficiency by all of the following EXCEPT:
-transferring the management of costs to the insureds
-controlling inpatient admissions and length of stay
, -increasing beneficiary cost sharing
-selectively contracting with health care providers -✓✓ -transferring the
management of costs to the insureds
MANAGED CARE PLANS ARE DESIGNED TO USE COST SAVING
SERVICES BY USING CLOSED NETWORKS AND MANAGING HEALTH
CARE WITH THESE NETWORKS
• Under an individual policy, and insured who CANNOT perform the duties of
his/her own occupation for a specific period of time is:
-totally disabled
-permanently disabled
-residually disabled
-occupationally disabled -✓✓ -totally disabled
TOTAL DISABILITY IS DEFINED AS THE INABILITY OF INSURED TO
PERFORM ALL THE DUTIES OF HIS REGULAR OCCUPATION FOR THE
FIRST 24 MONTHS AFTER A LOSS
• How do most disability policies handle the case of a recurrent disability occurring
at least 90 days after the first claim?
-it is excluded from coverage because benefits have already been paid
-it must be handled as a new claim for a new period of disability
-it is handled as a continuation of the existing claim
-it must be handled as new claim for a new period of disability, requiring a new
elimination period -✓✓ -it must be handled as a new claim for a new period of
disability, requiring a new elimination period
