NJ HEALTH AND ACCIDENT INSURANCE ACTUAL EXAM PRACTICE QUESTIONS WITH ACCURATE ANSWERS

NJ HEALTH AND ACCIDENT INSURANCE ACTUAL EXAM PRACTICE QUESTIONS WITH ACCURATE ANSWERS 1. In what form do disability income policies typically pay benefits - ANSWER Periodic income 2. The Mandatory health policy provision states that the policy, including endorsements and attached papers, constitutes - ANSWER The entire insurance contract between the parties 3. The entire contract includes the actual policy and the - ANSWER application 4. Kathy pays a monthly premium on her health insurance policy. How long is her grace period? - ANSWER 10 days 5. Insurance licenses are intended to be issued for the purpose of authorizing the transaction of business with members of the general public and not primarily allowing someone to benefit from commissions on business that insurers their personal interest. The description of which of the following? - ANSWER Controlled business 6. A master contract and certified coverage can be found in which type of policy? - ANSWER Group 7. Medicaid is a government-funded program designed to provide health care to - ANSWER poor people 8. Which type of long-term care benefit would be most appropriate for a stroke victim who requires speech therapy administered at her home? - ANSWER Home Health Care 9. What does the Consolidated Omnibus Budget Reconciliation Act (COBRA) of 1985 allow an employee to do? - ANSWER In the event of employment termination, group health insurance can be kept if the employee pays the premiums 10. Replacement regulation is designed to protect the interests of - ANSWER Policy owners 11. Continued coverage under COBRA would be provided to all of the following except? - ANSWER a covered employee is terminated for gross misconduct 12. A health insurer must be provided with written proof of loss ______ days after the date of loss - ANSWER 90 days 13. All of the following are factors would affect a health insurance policies premium rate Except - ANSWER Residential address of the insured 14. Which of the following is NOT a required provision in an accident and health insurance policy? - ANSWER Change of occupation (considered optional provision) 15. Within how many days must a producer notify the Department of Banking and Insurance of a change in address? - ANSWER 30 days 16. When comparing an HMO, to a PPO, the PPO - ANSWER provides a greater choice of providers 17. Under the Consolidated Omnibus Budget Reconciliation Act (COBRA), a terminated employee's benefits must - ANSWER be the same and the premium cannot exceed 102% 18. An agent is required to keep replacement forms on file for at LEAST ______ years. - ANSWER 5 years 19. employer sponsored group health insurance provides coverage for which of the following - ANSWER Alcoholism 20. The term which describes the fact that both parties of a contract may not receive the same value is referred to as - ANSWER Aleatory 21. Tom has a home health care benefit and is confined to his home. Which of these is NOT typically covered - ANSWER Full-time nursing care 22. A Medicare Supplement policy can be cancelled by the insurer for - ANSWER Nonpayment 23. Credit Accident and Health plans are designed to - ANSWER help pay off existing loans during periods of disability 24. A payment system for health care in which the provider is paid for each service given is called - ANSWER fee-for-service 25. An insurance company ONLY pay a sales commission to - ANSWER individuals licensed by the state 26. Ken is a producer who has obtained Consumer Information Reports under false pretenses. Under the Fair Credit Reporting Act, what is the maximum penalty that may be imposed on Ken? - ANSWER $5000 and 1 year imprisonment 27. A closed network plan offers a primary physician copay of $25. If a subscriber chooses a primary care physician outside of the network, the subscriber will likely pay - ANSWER 100% of the billed amount 28. What is the maximum fine for a producer violating an NJ insurance law for the first time? - ANSWER $5000 29. A licensed producer is required to file notice to any changes of address within how many days - ANSWER 30 days 30. Jonas has disability insurance through his employer. The employer pays 75% of the premium, and Jonas pays the other 25%. What is Jonas's tax liability for any benefits paid from the disability plan? - ANSWER Taxes must be paid on 75% of the benefits received 31. After an insured gives notice of loss, what must he/she do if the insurer does not furnish forms? - ANSWER File written proof of loss