NJ Health and Accident Questions and Answers
100% Pass
In what form do disability income policies typically pay benefits - Periodic income
The Mandatory health policy provision states that the policy, including endorsements
and attached papers, constitutes - The entire insurance contract between the parties
The entire contract includes the actual policy and the - application
employer sponsored group health insurance provides coverage for which of the
following - Alcoholism
The term which describes the fact that both parties of a contract may not receive the
same value is referred to as - Aleatory
Tom has a home health care benefit and is confined to his home. Which of these is NOT
typically covered - Full-time nursing care
A Medicare Supplement policy can be cancelled by the insurer for - Nonpayment
Credit Accident and Health plans are designed to - 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 - fee-for-service
An insurance company ONLY pay a sales commission to - individuals licensed by the
state
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? - $5000 and 1 year 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 - 100% of
the billed amount
What is the maximum fine for a producer violating an NJ insurance law for the first time?
- $5000
A licensed producer is required to file notice to any changes of address within how
many days - 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? - 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? - File written proof of loss
Which of the following is an example of the insured's consideration? - A paid premium
A(n) _______ insurance company is one that was formed under the laws of a state
other than NJ - Foreign
Kathy pays a monthly premium on her health insurance policy. How long is her grace
period? - 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? - Controlled business
A master contract and certified coverage can be found in which type of policy? - Group
Medicaid is a government-funded program designed to provide health care to - poor
people
Which type of long-term care benefit would be most appropriate for a stroke victim who
requires speech therapy administered at her home? - Home Health Care
What does the Consolidated Omnibus Budget Reconciliation Act (COBRA) of 1985
allow an employee to do? - 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 - Policy owners
Continued coverage under COBRA would be provided to all of the following except? - a
covered employee is terminated for gross misconduct
A health insurer must be provided with written proof of loss ______ days after the date
of loss - 90 days
All of the following are factors would affect a health insurance policies premium rate
Except - Residential address of the insured
Which of the following is NOT a required provision in an accident and health insurance
policy? - Change of occupation (considered optional provision)
, How long after being entitled to disability benefits will an individual be eligible to receive
Medicare benefits?
A. immediately
B. 1 year
C. 2 years
D. At age 65 - Correct answer-2 years
What is the return of premium rider?
A. an increasing amount of term insurance that always equals the total of premiums
paid up to the current point
B. a provision that allows the insured to cancel the policy in the first two years and have
premiums refunded
C. an increasing amount of term insurance that equals the cash value of the policy at
any point in time
D. a provision that states the insurer must return any premiums paid during the free-look
period - Correct answer-an increasing amount of term insurance that always equals the
total of premiums paid up to the current point
In a home healthcare benefit, all of the following are eligible expenses EXCEPT
A. intermittent part-time nursing care;
B. physical, occupational, or speech therapy;
C. blood transfusions
D. medical social services; - Correct answer-blood transfusions
All of the following are classifications of risk EXCEPT
A. substandard
B. preferred
C. declined
D. non-nicotine - Correct answer-non-nicotine
Which of the following is exempted from the incontestability provision in insurance
policies?
A. fraudulent misstatements
B. pre-existing conditions
C. change in health
D. changes in the insurance code - Correct answer-fraudulent misstatements
A group conversion option may be used in all the following instances EXCEPT
A. the termination of the master policy.
B. loss of coverage due to loss of employment.
C. loss of eligibility on the part of a class of insureds.
D. a life-changing event, such as marriage, divorce, or childbirth. - Correct answer-a life-
changing event, such as marriage, divorce, or childbirth.
100% Pass
In what form do disability income policies typically pay benefits - Periodic income
The Mandatory health policy provision states that the policy, including endorsements
and attached papers, constitutes - The entire insurance contract between the parties
The entire contract includes the actual policy and the - application
employer sponsored group health insurance provides coverage for which of the
following - Alcoholism
The term which describes the fact that both parties of a contract may not receive the
same value is referred to as - Aleatory
Tom has a home health care benefit and is confined to his home. Which of these is NOT
typically covered - Full-time nursing care
A Medicare Supplement policy can be cancelled by the insurer for - Nonpayment
Credit Accident and Health plans are designed to - 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 - fee-for-service
An insurance company ONLY pay a sales commission to - individuals licensed by the
state
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? - $5000 and 1 year 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 - 100% of
the billed amount
What is the maximum fine for a producer violating an NJ insurance law for the first time?
- $5000
A licensed producer is required to file notice to any changes of address within how
many days - 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? - 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? - File written proof of loss
Which of the following is an example of the insured's consideration? - A paid premium
A(n) _______ insurance company is one that was formed under the laws of a state
other than NJ - Foreign
Kathy pays a monthly premium on her health insurance policy. How long is her grace
period? - 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? - Controlled business
A master contract and certified coverage can be found in which type of policy? - Group
Medicaid is a government-funded program designed to provide health care to - poor
people
Which type of long-term care benefit would be most appropriate for a stroke victim who
requires speech therapy administered at her home? - Home Health Care
What does the Consolidated Omnibus Budget Reconciliation Act (COBRA) of 1985
allow an employee to do? - 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 - Policy owners
Continued coverage under COBRA would be provided to all of the following except? - a
covered employee is terminated for gross misconduct
A health insurer must be provided with written proof of loss ______ days after the date
of loss - 90 days
All of the following are factors would affect a health insurance policies premium rate
Except - Residential address of the insured
Which of the following is NOT a required provision in an accident and health insurance
policy? - Change of occupation (considered optional provision)
, How long after being entitled to disability benefits will an individual be eligible to receive
Medicare benefits?
A. immediately
B. 1 year
C. 2 years
D. At age 65 - Correct answer-2 years
What is the return of premium rider?
A. an increasing amount of term insurance that always equals the total of premiums
paid up to the current point
B. a provision that allows the insured to cancel the policy in the first two years and have
premiums refunded
C. an increasing amount of term insurance that equals the cash value of the policy at
any point in time
D. a provision that states the insurer must return any premiums paid during the free-look
period - Correct answer-an increasing amount of term insurance that always equals the
total of premiums paid up to the current point
In a home healthcare benefit, all of the following are eligible expenses EXCEPT
A. intermittent part-time nursing care;
B. physical, occupational, or speech therapy;
C. blood transfusions
D. medical social services; - Correct answer-blood transfusions
All of the following are classifications of risk EXCEPT
A. substandard
B. preferred
C. declined
D. non-nicotine - Correct answer-non-nicotine
Which of the following is exempted from the incontestability provision in insurance
policies?
A. fraudulent misstatements
B. pre-existing conditions
C. change in health
D. changes in the insurance code - Correct answer-fraudulent misstatements
A group conversion option may be used in all the following instances EXCEPT
A. the termination of the master policy.
B. loss of coverage due to loss of employment.
C. loss of eligibility on the part of a class of insureds.
D. a life-changing event, such as marriage, divorce, or childbirth. - Correct answer-a life-
changing event, such as marriage, divorce, or childbirth.
