Health Final Exam - NJ Accident and Health Questions and Verified Answers

Health Final Exam - NJ Accident and Health
Questions and Verified Answers



1. The Commissioner must approve: Continuing education courses
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2. Employer sponsored group health insurance provides coverage for which of the follow
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ing?

Self-
inflicted injuries cosmeti k k


c surgery custodial care a
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lcoholism: alcoholism k


3. A Medicare supplement policy can be cancelled by the insurer for: Nonpay- ment
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4. Which entity is responsible for regulating insurance advertising in NJ?: New Jersey Depart
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ment of Banking and Insurance
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5. Which of the following are retained at the expense of an insurance buyer to give advice
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on insurance needed by the buyer?
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Brokers and consultants Insu k k k


rance prospectors Third-
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party adminstrators
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Agents: Brokers and consultants
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6. Written notice for a health claim must be given to the insurer
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days after the occurrence of the loss.: 20
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7. In which of the following situations would the insurer be liable for a loss?
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a) The insured skipped a payment beyond the 31 day grace period
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b) The insured was injured while participating in an illegal occupation
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c) The insured was given a notice of cancellation from the insurer
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d) The insured suffered an injury as an innocent bystander during a bank robbery: d) The i
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1k/k21

,nsured suffered an injury as an innocent bystander during a bank robbery
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8. When a Medicare supplement policy is purchased during the open enroll-
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ment period: The policy must be issued regardless of health status
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9. In what form do disability income policies typically pay benefits?: Periodic income
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10. What is considered to be the primary reason for buying life insurance?: -
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Provide death benefits
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11. A newborn is required to be covered for
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days from the moment of birth: 30
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12. Once an accident and health insurance policy has been in force for
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kyear(s), the policy may NOT be contested by the insurer: 2
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2k/k21

, 13. A doctor who accepts Medicare assignment agrees to which of the follow- ing
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- Doctor may charge up to a maximum of 15% more than Medicare pays for the service
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- Doctor is not bound by Medicare's limitations on charges
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- Doctor cannot charge more than Medicare's scheduled coverage
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- Doctor bills the Medicare beneficiary directly for services performed: Doctor cannot cha
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rge more than Medicare's scheduled coverage
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14. What is issued to each employee with an employer health plan?: Certificate
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15. What is the tax liability for employer contributions in Health Savings Ac-
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kcounts (HSA's)?: No tax payment needed k k k k k


16. All of these are considered sources of information that can assist an underwrite
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r in determining whether or not to accept a risk EXCEPT
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Agent's report k


Medical Information Bureau (MIB) Inspect k k k k


ion reports k


National Association of Insurance Underwriters: National Association of Insur-
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kance Underwriters k


17. In NJ, health insurance advertisements are required to contain the: insur-
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kance company's name k k


18. Replacement regulation is designed to protect the interests of: Policyown- ers k k k k k k k k k k


19. The Commissioner of Insurance is appointed by: The governor
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20. Which type of plan would be most appropriate for an individual on Medicare and is co
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ncerned that Medicare will NOT pay for charges exceeding the approved amount?: Medica
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re supplement plan F
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21. Which of the following is NOT a common exclusion for a medical expense policy?
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Physical therapy A k k


ct of war k k


on the job injury k k k


self inflicted injury: Physical therapy
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22. Twisting is best defined as: using misrepresentation to induce an insured person to t
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3k/k21