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Exam (elaborations)

New Jersey Health and Accident Insurance Exam – State Licensing Course – Practice Questions and Verified Answers Study Guide

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This document contains practice questions and verified answers designed to prepare candidates for the New Jersey Health and Accident Insurance exam. It covers key topics such as policy provisions, underwriting, health insurance plans, state regulations, and ethics. The material reflects commonly tested concepts and supports effective exam preparation. It is suitable for learners seeking a structured and comprehensive review aligned with state licensing requirements.

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NJ HEALTH AND ACCIDENT
INSURANCE ACTUAL EXAM
QUESTIONS AND 100% CORRECT
ANSWERS / NEW JERSEY HEALTH
AND ACCIDENT EXAM WITH 300+
QUESTIONS AND VERIFIED
ANSWERS GRADE A+
Employer sponsored group health insurance provides coverage for which of the
following?



Self-inflicted injuries

cosmetic surgery

custodial care

alcoholism - answer-alcoholism



The Commissioner must approve - answer-Continuing education courses



A Medicare supplement policy can be cancelled by the insurer for - answer-
Nonpayment



Which entity is responsible for regulating insurance advertising in NJ? - answer-New
Jersey Department of Banking and Insurance



Which of the following are retained at the expense of an insurance buyer to give advice
on insurance needed by the buyer?



Brokers and consultants

Insurance prospectors

,Third-party adminstrators

Agents - answer-Brokers and consultants



Written notice for a health claim must be given to the insurer ___ days after the
occurrence of the loss. - answer-20



In which of the following situations would the insurer be liable for a loss?



a) The insured skipped a payment beyond the 31 day grace period

b) The insured was injured while participating in an illegal occupation

c) The insured was given a notice of cancellation from the insurer

d) The insured suffered an injury as an innocent bystander during a bank robbery -
answer-d) The insured suffered an injury as an innocent bystander during a bank
robbery



When a Medicare supplement policy is purchased during the open enrollment period -
answer-The policy must be issued regardless of health status



In what form do disability income policies typically pay benefits? - answer-Periodic
income



What is considered to be the primary reason for buying life insurance? - answer-Provide
death benefits



A newborn is required to be covered for ____ days from the moment of birth - answer-30



Once an accident and health insurance policy has been in force for ___ year(s), the
policy may NOT be contested by the insurer - answer-2



A doctor who accepts Medicare assignment agrees to which of the following

, - Doctor may charge up to a maximum of 15% more than Medicare pays for the service

- Doctor is not bound by Medicare's limitations on charges

- Doctor cannot charge more than Medicare's scheduled coverage

- Doctor bills the Medicare beneficiary directly for services performed - answer-Doctor
cannot charge more than Medicare's scheduled coverage



What is issued to each employee with an employer health plan? - answer-Certificate



What is the tax liability for employer contributions in Health Savings Accounts (HSA's)? -
answer-No tax payment needed



All of these are considered sources of information that can assist an underwriter in
determining whether or not to accept a risk EXCEPT



Agent's report

Medical Information Bureau (MIB)

Inspection reports

National Association of Insurance Underwriters - answer-National Association of
Insurance Underwriters



In NJ, health insurance advertisements are required to contain the - answer-insurance
company's name



Replacement regulation is designed to protect the interests of - answer-Policyowners



The Commissioner of Insurance is appointed by - answer-The governor

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