Health Final Exam - NJ Accident and Health questions and solutions

The Commissioner must approve - Continuing education courses Employer sponsored group health insurance provides coverage for which of the following? Self-inflicted injuries cosmetic surgery custodial care alcoholism - alcoholism A Medicare supplement policy can be cancelled by the insurer for - Nonpayment Which entity is responsible for regulating insurance advertising in NJ? - 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 - Brokers and consultants Written notice for a health claim must be given to the insurer ___ days after the occurrence of the loss. - 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 - 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 - The policy must be issued regardless of health status In what form do disability income policies typically pay benefits? - Periodic income What is considered to be the primary reason for buying life insurance? - Provide death benefits A newborn is required to be covered for ____ days from the moment of birth - 30 Once an accident and health insurance policy has been in force for ___ year(s), the policy may NOT be contested by the insurer - 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 - Doctor cannot charge more than Medicare's scheduled coverage What is issued to each employee with an employer health plan? - Certificate