NJ Health and accidental Practice final exam excel Questions and Verified Answers

NJ Health and accidental Practice final exam
excel Questions and Verified Answers



1. A long-term care policy typically provides all of the following levels of care EXCEPT
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Skilled care Intermed r r


iate care Acute care
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Custodial care: acute care r r r


2. All of the following are included as part of a contract in the entire contract provision EXC
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EPT the: r


Riders applicatio r


n
Changes made by the producer: changes made by the producer
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3. An insurance company may ONLY pay a sales commission to: Individuals
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who are residents of this state for at least 5 years Individuals who are registe
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red with the NAIC
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Individuals licensed by the state r r r r


Individuals who are gainfully employment by that insurance company: Individ-
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uals licensed by the state
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4. The law established insurance transactions should be regulated by the states is call
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ed the
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McCarran-
Ferguson Act Mccain- r r


Feingold act r


Fair credit Reporting Act
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Paul vs Virginia: McCarren-Ferguson Act
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5. In a group medical expense health insurance plan, coverage for alcoholism is treated as::
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rAny other illness, sickness or disease
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6. A producer must notify the Commissioner within
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, days of a felony conviction.
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15
30
45
60: 30
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7. The purpose of Medicare Supplement Insurance is to address gaps in Medicare cov
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erage, which can include?
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Medicare in hospital deductible repla
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cing HMO coverage Covering chiropra
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ctic treatment
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Treatment provided in a government hospital: Medicare in-hospital deductible
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,8. in in New Jersey, health insurance advertisements are required to contain the
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Insurance company's trademark Insurance r r r r


company's name Insurance company's AM r r r r r


Best rating r


Insurance company's current standing with the better business Bureau: Insur-
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ance company's name
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9. States that have "no loss no gain" laws require a replacing policy to....
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Keep the same type if coverage as the policy it replaces Not change a d
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ifferent premium from the policy if replaces
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pay for half of any ongoing claims under the policy it replaces
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Pay for ongoing claims under the policy it replaces: Pay for ongoing claims under the policy it r
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eplaces
10. Which of the following is NOT a required provision in an accident and health insura
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nce policy?
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Legal actions grace pe
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riod
Change of occupation reinstatement: chan
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ge of occupation
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11. In group health care, what is the purpose of the coordination of benefits provision?
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Determines where as insured goes to receive treatment r r r r r r r


Determines what is paid by the primary and secondary insurers in the event of a claim
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Ensures that a health provider receives the proper benefit amount owed Determines which
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arent plan covers a department child: Determines what is paid by the primary and secondary in
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urers in the event of a claim
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12. An accident and health insurer has just received written proof of loss from one of its insu
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reds.The insured must now wait 60 days before
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Submitting another claim r r



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, bringing legal actions against the insurer the insur
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er will pay the claim
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purchasing more insurance from this insurer: bringing legal action against the insurer
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