pg. 1 NJ HEALTH AND ACCIDENT INSURANCE ACTUAL EXAM 2024 -2025 QUESTIONS AND 100% CORRECT ANSWERS / NEW JERSEY HEALTH AND ACCIDENT EXAM 2024 WITH 300+ QUESTIONS AND ANSWERS What is the maximum fine for a prod ucer violating an NJ insurance law for the first time? - ANSWER -$5000 A(n) _______ insurance company is one that was formed under the laws of a state other tha n NJ - ANSWER -Foreign Medicaid is a government -funded program designed to provide health care to - ANSWER -poor people When a producer, domiciled in New York, with an office location in NJ, elects NJ as their r esident state, he is acting as - ANSWER -A resident licensee in NJ A licensed producer is required to file notice to any changes of address within how many days - ANSWER -30 days 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 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 pg. 2 Which of the following is an example of the insured's consideration? - ANSWER -
A paid premium In what form do disability income policies typically pay benefits - ANSWER -
Periodic income The Mandatory health policy provision states that the policy, including endorsements and attached papers, constitutes - ANSWER -The entire insurance contract between the parties The entire contract includes the actual policy and the - ANSWER -application 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 y ear imprisonment 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 Kathy pays a monthly premium on her health insurance policy. How long is her grace period? - ANSWER -10 days 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 pg. 3 employer sponsored group health insurance provides coverage for which of the following - ANSWER -Alcoholism The term which describes the fact that both parties of a contract may not receive the same value is referred to as - ANSWER -Aleatory 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 A Medicare Supplement policy can be cancelled by the insurer for - ANSWER -
Nonpayment Credit Accident and Heal th plans are designed to - ANSWER -help pay off existing loans during periods of disability A payment system for health care in which the provider is paid for each service given is called - ANSWER -fee-for-service An insurance company ONLY pay a sales comm ission to - ANSWER -individuals licensed by the state A master contract and certified coverage can be found in which type of policy? - ANSWER -Group Which type of long -term care benefit would be most appropriate for a stroke victim who requires speech therapy adminis tered at her home? - ANSWER -Home Health Care pg. 4 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 Replacement regulation is designed to protect the interests of - ANSWER -Policy owners Continued coverage under COBRA would be provided to all of the following except? - ANSWER -a covered employee is terminated for gross misconduct A health insu rer must be provided with written proof of loss ______ days after the date of loss - ANSWER -90 days All of the following are factors would affect a health insurance policies premium rate Except - ANSWER -Residential address of the insured Which of the following is NOT a required provision in an accident and health insurance policy? - ANSWER -Change of occupation (considered optional provision) Within how many days must a producer notify the Department of Banking and Insurance of a change in address? - ANSWER -30 days When comparing an HMO, to a PPO, the PPO - ANSWER -provides a greater choice of providers Under the Consolidated Omnibus Budget Reconciliation Act (COBRA), a terminated employee's benefits must - ANSWER -be the same and the premium cannot exc eed 102%
A paid premium In what form do disability income policies typically pay benefits - ANSWER -
Periodic income The Mandatory health policy provision states that the policy, including endorsements and attached papers, constitutes - ANSWER -The entire insurance contract between the parties The entire contract includes the actual policy and the - ANSWER -application 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 y ear imprisonment 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 Kathy pays a monthly premium on her health insurance policy. How long is her grace period? - ANSWER -10 days 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 pg. 3 employer sponsored group health insurance provides coverage for which of the following - ANSWER -Alcoholism The term which describes the fact that both parties of a contract may not receive the same value is referred to as - ANSWER -Aleatory 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 A Medicare Supplement policy can be cancelled by the insurer for - ANSWER -
Nonpayment Credit Accident and Heal th plans are designed to - ANSWER -help pay off existing loans during periods of disability A payment system for health care in which the provider is paid for each service given is called - ANSWER -fee-for-service An insurance company ONLY pay a sales comm ission to - ANSWER -individuals licensed by the state A master contract and certified coverage can be found in which type of policy? - ANSWER -Group Which type of long -term care benefit would be most appropriate for a stroke victim who requires speech therapy adminis tered at her home? - ANSWER -Home Health Care pg. 4 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 Replacement regulation is designed to protect the interests of - ANSWER -Policy owners Continued coverage under COBRA would be provided to all of the following except? - ANSWER -a covered employee is terminated for gross misconduct A health insu rer must be provided with written proof of loss ______ days after the date of loss - ANSWER -90 days All of the following are factors would affect a health insurance policies premium rate Except - ANSWER -Residential address of the insured Which of the following is NOT a required provision in an accident and health insurance policy? - ANSWER -Change of occupation (considered optional provision) Within how many days must a producer notify the Department of Banking and Insurance of a change in address? - ANSWER -30 days When comparing an HMO, to a PPO, the PPO - ANSWER -provides a greater choice of providers Under the Consolidated Omnibus Budget Reconciliation Act (COBRA), a terminated employee's benefits must - ANSWER -be the same and the premium cannot exc eed 102%
