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Exam (elaborations)

NJ HEALTH AND ACCIDENT INSURANCE ACTUAL EXAM QUESTIONS AND CORRECT ANSWERS |LATEST UPDATE

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This document contains a comprehensive collection of actual exam-style questions and correct answers for the New Jersey Health and Accident Insurance licensing exam. It covers key topics such as policy provisions, Medicare and Medicaid, underwriting, state regulations, and insurance principles. The material is structured in a Q&A format, making it ideal for exam preparation and self-testing. It reflects commonly tested concepts and aligns closely with real exam content.

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NJ HEALTH AND ACCIDENT INSURANCE
ACTUAL EXAM QUESTIONS AND CORRECT
ANSWERS |LATEST UPDATE



A long-term care policy typically provides all of the following levels of care EXCEPT
Skilled care
Intermediate care
Acute care
Custodial care
acute care




All of the following are included as part of a contract in the entire contract
provision EXCEPT the:
Riders
application
Changes made by the producer
changes made by the producer




An insurance company may ONLY pay a sales commission to:
Individuals who are residents of this state for at least 5 years

,Individuals who are registered with the NAIC
Individuals licensed by the state
Individuals who are gainfully employment by that insurance company
Individuals licensed by the state




The law established insurance transactions should be regulated by the states is
called the
McCarran-Ferguson Act
Mccain-Feingold act
Fair credit Reporting Act
Paul vs Virginia
McCarren-Ferguson Act




In a group medical expense health insurance plan, coverage for alcoholism is
treated as:
Any other illness, sickness or disease




A producer must notify the Commissioner within ___ days of a felony conviction.
15
30
45

,60
30




The purpose of Medicare Supplement Insurance is to address gaps in Medicare
coverage, which can include?
Medicare in hospital deductible
replacing HMO coverage
Covering chiropractic treatment
Treatment provided in a government hospital
Medicare in-hospital deductible




in in New Jersey, health insurance advertisements are required to contain the
Insurance company's trademark
Insurance company's name
Insurance company's AM Best rating
Insurance company's current standing with the better business Bureau
Insurance company's name




States that have "no loss no gain" laws require a replacing policy to....
Keep the same type if coverage as the policy it replaces

, Not change a different premium from the policy if replaces
pay for half of any ongoing claims under the policy it replaces
Pay for ongoing claims under the policy it replaces
Pay for ongoing claims under the policy it replaces




Which of the following is NOT a required provision in an accident and health
insurance policy?
Legal actions
grace period
Change of occupation
reinstatement
change of occupation




In group health care, what is the purpose of the coordination of benefits provision?
Determines where as insured goes to receive treatment
Determines what is paid by the primary and secondary insurers in the event of a
claim
Ensures that a health provider receives the proper benefit amount owed
Determines which parent plan covers a department child
Determines what is paid by the primary and secondary insurers in the event of a
claim

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