NJ HEALTH INSURANCE EXAM (XCEL
SOLUTIONS) QUESTIONS WITH
CORRECT ANSWERS
Joe is a Medicare participant who receives his benefits through a Managed Health
Care Plan. Which Medicare plan does he have? - ANSWER-Part C
A Medicare Supplement policy must not contain benefits which - ANSWER-duplicate
Medicare benefits
Which of these gaps in Medicare coverage is addressed with Medicare
Supplemental Insurance? - ANSWER-Medicare in-hospital deductible
All _____ policies must be guaranteed renewable. - ANSWER-long-term care
All of the following are core benefits of Medicare Supplement Plan A EXCEPT
deductible payments for the first 60 days of hospitalization under Medicare
hospitalization insurance
Medicare part A hospice coinsurance or copayment
Medicare part B coinsurance or copayment
the first three pints of blood received - ANSWER-deductible payments for the first 60
days of hospitalization under Medicare hospitalization insurance
The open enrolment period for Medicare Supplements begins at age - ANSWER-65
Which of the following provides Medicare supplement policies? - ANSWER-private
insurance companies
Long-Term Care policies may provide coverage for claims arising from - ANSWER-
senile dementia
Respite care is able to provide - ANSWER-temporary relief to the patient's primary
caregiver
Which of the following does Medicare Part D cover? - ANSWER-prescription drugs
Which of the following statements is TRUE about Medicaid? - ANSWER-it is funded
by federal, state, and local taxes
The difference between a Long Term Care Partnership Plan and a Non-Partnership
Plan is which of the following? - ANSWER-asset protection
Which type of plan would be most appropriate for an individual on Medicare and is
concerned that Medicare will NOT pay for charges exceeding the approved amount?
- ANSWER-medicare supplement plan F
,Premiums paid that exceed 7 12% of an insured's Adjusted Gross Income (AGI) are
tax-deductible when paid for which of the following plans? - ANSWER-qualified long
term care plan
The purpose of Medicare Supplement Insurance is to address gaps in Medicare
coverage, which can include - ANSWER-medicare in-hospital deductible
Which of the following nursing home option would BEST suit an individual who
needs some nursing care and supervision but NOT full-time care? - ANSWER-
assisted living facilities
In a Long-Term Care policy, activities of daily living (ADL's) can be each of the
following EXCEPT
talking
dressing
transferring
feeding oneself - ANSWER-talking
Tom has a home health care benefit and is confined to his home. Which of these
benefits is NOT typically covered?
part-time nursing care
full-time nursing care
physical therapy
home health aides - ANSWER-full-time nursing care
Which type of long-term care benefit would be most appropriate for a stroke victim
who requires speech therapy administered at her home? - ANSWER-home health
care
Which type of business insurance is meant to cover the costs of continuing to do
business while the owner is disabled? - ANSWER-business overhead expense
policy
Without a Section 125 Plan in place, what would happen to an employee's payroll
contribution to an HSA? - ANSWER-it would be considered taxable income to the
employee
The purpose of the Coordination of benefits provision in group accident and health
plans is to - ANSWER-avoid overpayment of claims
The policyholder for a group health benefit plan is considered to be the - ANSWER-
employer
Under the Consolidated Omnibus Budget Reconciliation Act (COBRA), a terminated
employee's benefits must - ANSWER-be the same and the premium cannot exceed
102%
A group Disability Income plan that pays tax-free benefits to covered employees is
considered - ANSWER-fully contributory
, In an employer-sponsored group accident and health plan, a master contract is
issued to the - ANSWER-employer
Sole proprietors are permitted tax deductions for health costs paid from their
earnings in the amount of - ANSWER-100% of costs
The election of COBRA for continuation of health coverage will - ANSWER-maintain
the same coverage and increase premium
An employer is issued a group medical insurance policy. This single contract is
known as a(n) - ANSWER-master policy
Health insurance involves two perils, accident and _____ - ANSWER-sickness
Under the Health Insurance Portability and Accountability Act (HIPAA), the
employee's new Group Health Plan will verify Creditable Coverage so that the -
ANSWER-employee's waiting period for coverage of a preexisting condition can be
reduced under the new employer's health plan
When are group disability benefits considered to be tax-free to the insured? -
ANSWER-when the recipient pays the premium
Ron has a new employer and wishes to enroll in the company's group health plan. In
determining whether his pre-existing health condition applies. Ron cannot have more
than a _____ day gap without previous health insurance - ANSWER-63
Which of the following would be considered a possible applicant and contract
policyholder for group health benefits? - ANSWER-employer
Continued coverage under COBRA would be provided to all of the following
EXCEPT
former dependent of employee no longer of dependent status
terminated employee
divorced spouse of employee
a covered employee is terminated for gross misconduct - ANSWER-a covered
employee is terminated for gross misconduct
What is issued to each employee of an employer health plan? - ANSWER-certificate
Health insurance will typically cover which of the following perils? - ANSWER-injury
due to accident
Under group health insurance, a certificate of coverage is issued to the - ANSWER-
employee
Mark continues working after the age of 65 and is covered through his employer's
group health plan. Which of the following statements is TRUE? - ANSWER-medicare
is the secondary payer
SOLUTIONS) QUESTIONS WITH
CORRECT ANSWERS
Joe is a Medicare participant who receives his benefits through a Managed Health
Care Plan. Which Medicare plan does he have? - ANSWER-Part C
A Medicare Supplement policy must not contain benefits which - ANSWER-duplicate
Medicare benefits
Which of these gaps in Medicare coverage is addressed with Medicare
Supplemental Insurance? - ANSWER-Medicare in-hospital deductible
All _____ policies must be guaranteed renewable. - ANSWER-long-term care
All of the following are core benefits of Medicare Supplement Plan A EXCEPT
deductible payments for the first 60 days of hospitalization under Medicare
hospitalization insurance
Medicare part A hospice coinsurance or copayment
Medicare part B coinsurance or copayment
the first three pints of blood received - ANSWER-deductible payments for the first 60
days of hospitalization under Medicare hospitalization insurance
The open enrolment period for Medicare Supplements begins at age - ANSWER-65
Which of the following provides Medicare supplement policies? - ANSWER-private
insurance companies
Long-Term Care policies may provide coverage for claims arising from - ANSWER-
senile dementia
Respite care is able to provide - ANSWER-temporary relief to the patient's primary
caregiver
Which of the following does Medicare Part D cover? - ANSWER-prescription drugs
Which of the following statements is TRUE about Medicaid? - ANSWER-it is funded
by federal, state, and local taxes
The difference between a Long Term Care Partnership Plan and a Non-Partnership
Plan is which of the following? - ANSWER-asset protection
Which type of plan would be most appropriate for an individual on Medicare and is
concerned that Medicare will NOT pay for charges exceeding the approved amount?
- ANSWER-medicare supplement plan F
,Premiums paid that exceed 7 12% of an insured's Adjusted Gross Income (AGI) are
tax-deductible when paid for which of the following plans? - ANSWER-qualified long
term care plan
The purpose of Medicare Supplement Insurance is to address gaps in Medicare
coverage, which can include - ANSWER-medicare in-hospital deductible
Which of the following nursing home option would BEST suit an individual who
needs some nursing care and supervision but NOT full-time care? - ANSWER-
assisted living facilities
In a Long-Term Care policy, activities of daily living (ADL's) can be each of the
following EXCEPT
talking
dressing
transferring
feeding oneself - ANSWER-talking
Tom has a home health care benefit and is confined to his home. Which of these
benefits is NOT typically covered?
part-time nursing care
full-time nursing care
physical therapy
home health aides - ANSWER-full-time nursing care
Which type of long-term care benefit would be most appropriate for a stroke victim
who requires speech therapy administered at her home? - ANSWER-home health
care
Which type of business insurance is meant to cover the costs of continuing to do
business while the owner is disabled? - ANSWER-business overhead expense
policy
Without a Section 125 Plan in place, what would happen to an employee's payroll
contribution to an HSA? - ANSWER-it would be considered taxable income to the
employee
The purpose of the Coordination of benefits provision in group accident and health
plans is to - ANSWER-avoid overpayment of claims
The policyholder for a group health benefit plan is considered to be the - ANSWER-
employer
Under the Consolidated Omnibus Budget Reconciliation Act (COBRA), a terminated
employee's benefits must - ANSWER-be the same and the premium cannot exceed
102%
A group Disability Income plan that pays tax-free benefits to covered employees is
considered - ANSWER-fully contributory
, In an employer-sponsored group accident and health plan, a master contract is
issued to the - ANSWER-employer
Sole proprietors are permitted tax deductions for health costs paid from their
earnings in the amount of - ANSWER-100% of costs
The election of COBRA for continuation of health coverage will - ANSWER-maintain
the same coverage and increase premium
An employer is issued a group medical insurance policy. This single contract is
known as a(n) - ANSWER-master policy
Health insurance involves two perils, accident and _____ - ANSWER-sickness
Under the Health Insurance Portability and Accountability Act (HIPAA), the
employee's new Group Health Plan will verify Creditable Coverage so that the -
ANSWER-employee's waiting period for coverage of a preexisting condition can be
reduced under the new employer's health plan
When are group disability benefits considered to be tax-free to the insured? -
ANSWER-when the recipient pays the premium
Ron has a new employer and wishes to enroll in the company's group health plan. In
determining whether his pre-existing health condition applies. Ron cannot have more
than a _____ day gap without previous health insurance - ANSWER-63
Which of the following would be considered a possible applicant and contract
policyholder for group health benefits? - ANSWER-employer
Continued coverage under COBRA would be provided to all of the following
EXCEPT
former dependent of employee no longer of dependent status
terminated employee
divorced spouse of employee
a covered employee is terminated for gross misconduct - ANSWER-a covered
employee is terminated for gross misconduct
What is issued to each employee of an employer health plan? - ANSWER-certificate
Health insurance will typically cover which of the following perils? - ANSWER-injury
due to accident
Under group health insurance, a certificate of coverage is issued to the - ANSWER-
employee
Mark continues working after the age of 65 and is covered through his employer's
group health plan. Which of the following statements is TRUE? - ANSWER-medicare
is the secondary payer
