NJ HEALTH AND ACCIDENT INSURANCE EXAM QUESTIONS
AND ANSWERS (VERIFIED AND WELL DETAILED ANSWERS)
LATEST UPDATE 2025/2026
NJ LAW:
What are the duties/responsibilities of the Commissioner? - CORRECT
ANSWER- - enforcing and administering all laws pertaining to
insurance
- make rules and regulations to help administer insurance code
- conduct examinations, administer oaths, question licensees, and issue
subpoenas
If the Commissioner finds that the producer has committed the alleged
acts or practice, they can order the producer..... - CORRECT
ANSWER- - cease and desist from committing the act or engaging in
the practice
- be fined up to $1000
- be fined up to $5000 if the person knew they were violating the law
What is the maximum fine imposed by the Commissioner on a
suspended Producer for their first offense? - CORRECT ANSWER- up
to $5000
,mutual insurers - CORRECT ANSWER- - owned by policyholders
- mutual company does not have permanent capital stock
- governing body elected by policyholders
Who may receive temporary work authority? - CORRECT ANSWER-
- those who submitted a licensing application and fee
- expires after 60 days
twisting - CORRECT ANSWER- misrepresentation or incomplete
comparison to induce a person to lapse, forfeit, or surrender insurance
Within how many days must an insurer respond to an inquiry from the
Department? - CORRECT ANSWER- 15 days
New Jersey Life and Health Insurance Guaranty Association -
CORRECT ANSWER- - protects the policyowner, insureds, and
beneficiaries if an insurer becomes impaired or insolvent and unable to
perform its contractual obligations
An insured cannot bring suit after how many years have passed since
filing proof of loss? - CORRECT ANSWER- 3 years
,How long does the insured have to submit proof of loss? - CORRECT
ANSWER- 90 days
How soon must a policyowner give written notice of claim to the
insurer? - CORRECT ANSWER- 20 days or as soon as reasonably
possible
How long does the pre-existing condition exclusion last? - CORRECT
ANSWER- up to 24 months
what benefits must be included for treatment of alcoholism? -
CORRECT ANSWER- - inpatient or outpatient care in a licensed
hospital
- treatment at a detoxification facility
- confinement as an inpatient or outpatient at a residential treatment
facility
a group health insurance plan may exclude pre-existing conditions for up
to how long after the effective date of coverage? - CORRECT
ANSWER- 12 months, or 18 months for late enrollees
How long is the extension of benefits under group plans? - CORRECT
ANSWER- extension of at least 12 months for major
medical/comprehensive medical/HMO plans
, if a person violates the solicitation regulations, the commissioner may -
CORRECT ANSWER- impose a penalty of up to $2,000 for each
violation, or revoke/suspend a person's license or certificate of authority
What does Medicare supplement policy do? - CORRECT ANSWER- -
fills the gap and picks up where Medicare coverage leaves off
- sold by private insurance companies
- covers most, if not all, of the coinsurance and deductible amounts and
also pay for various health services not covered by Medicare
- must allow for suspension of benefits and premiums at the
policyholder's request for up to 24 months
free-look period for Medicare supplement policy - CORRECT
ANSWER- at least 30 days
two ways a cafeteria plan can be set up - CORRECT ANSWER- - pre-
tax health insurance premium deductions
- unreimbursed medical expenses
pre-tax health insurance premium deductions - CORRECT ANSWER-
employee pre-tax salary is withheld to pay premium contributions to the
employer's group plan
AND ANSWERS (VERIFIED AND WELL DETAILED ANSWERS)
LATEST UPDATE 2025/2026
NJ LAW:
What are the duties/responsibilities of the Commissioner? - CORRECT
ANSWER- - enforcing and administering all laws pertaining to
insurance
- make rules and regulations to help administer insurance code
- conduct examinations, administer oaths, question licensees, and issue
subpoenas
If the Commissioner finds that the producer has committed the alleged
acts or practice, they can order the producer..... - CORRECT
ANSWER- - cease and desist from committing the act or engaging in
the practice
- be fined up to $1000
- be fined up to $5000 if the person knew they were violating the law
What is the maximum fine imposed by the Commissioner on a
suspended Producer for their first offense? - CORRECT ANSWER- up
to $5000
,mutual insurers - CORRECT ANSWER- - owned by policyholders
- mutual company does not have permanent capital stock
- governing body elected by policyholders
Who may receive temporary work authority? - CORRECT ANSWER-
- those who submitted a licensing application and fee
- expires after 60 days
twisting - CORRECT ANSWER- misrepresentation or incomplete
comparison to induce a person to lapse, forfeit, or surrender insurance
Within how many days must an insurer respond to an inquiry from the
Department? - CORRECT ANSWER- 15 days
New Jersey Life and Health Insurance Guaranty Association -
CORRECT ANSWER- - protects the policyowner, insureds, and
beneficiaries if an insurer becomes impaired or insolvent and unable to
perform its contractual obligations
An insured cannot bring suit after how many years have passed since
filing proof of loss? - CORRECT ANSWER- 3 years
,How long does the insured have to submit proof of loss? - CORRECT
ANSWER- 90 days
How soon must a policyowner give written notice of claim to the
insurer? - CORRECT ANSWER- 20 days or as soon as reasonably
possible
How long does the pre-existing condition exclusion last? - CORRECT
ANSWER- up to 24 months
what benefits must be included for treatment of alcoholism? -
CORRECT ANSWER- - inpatient or outpatient care in a licensed
hospital
- treatment at a detoxification facility
- confinement as an inpatient or outpatient at a residential treatment
facility
a group health insurance plan may exclude pre-existing conditions for up
to how long after the effective date of coverage? - CORRECT
ANSWER- 12 months, or 18 months for late enrollees
How long is the extension of benefits under group plans? - CORRECT
ANSWER- extension of at least 12 months for major
medical/comprehensive medical/HMO plans
, if a person violates the solicitation regulations, the commissioner may -
CORRECT ANSWER- impose a penalty of up to $2,000 for each
violation, or revoke/suspend a person's license or certificate of authority
What does Medicare supplement policy do? - CORRECT ANSWER- -
fills the gap and picks up where Medicare coverage leaves off
- sold by private insurance companies
- covers most, if not all, of the coinsurance and deductible amounts and
also pay for various health services not covered by Medicare
- must allow for suspension of benefits and premiums at the
policyholder's request for up to 24 months
free-look period for Medicare supplement policy - CORRECT
ANSWER- at least 30 days
two ways a cafeteria plan can be set up - CORRECT ANSWER- - pre-
tax health insurance premium deductions
- unreimbursed medical expenses
pre-tax health insurance premium deductions - CORRECT ANSWER-
employee pre-tax salary is withheld to pay premium contributions to the
employer's group plan
