Complete Questions and Answers 100% Pass
Study Guide
Introduction:
This document provides the complete collection of New Jersey
Health and Accident Insurance exam questions and verified
answers, designed to help students and professionals prepare for
licensing exams with confidence. Topics include policy provisions,
underwriting, claims, COBRA, HIPAA, Medicare, Medicaid, ACA
regulations, producer licensing, advertising rules, and state-specific
insurance laws. It also explains key insurance concepts such as
deductibles, co-payments, renewability provisions, and fraud
prevention. Perfect for exam preparation, review, or professional
reference in NJ insurance studies.
Exam Questions and Answers
Which of the following is NOT included under a health benefit plan?
--- correct answer ---Hospital indemnity plan
Once an accident and health insurance policy has been in force for
___ year(s), the policy may NOT be contested by the insurer ---
correct answer ---2 years
A medicare supplement policy must NOT contain benefits which ---
correct answer ---duplicate Medicare benefits
,The Commissioner may --- correct answer ---establish continuing
education requirements
Signatures for an insurance application MUST be obtained by the
producer from all of the following sources EXCEPT --- correct
answer ---the beneficiary
David submits a $500 claim for medical expenses. There is a past
due amount owed for insurance premiums of $200. As a result, the
insurer only pays $300 for the claim. The deduction came as a
result of which provision? --- correct answer ---unpaid provision
Who is the individual paid on a fee-for-service basis? --- correct
answer ---Provider
A producer's secretary who solicits prospects on the telephone ---
correct answer ---must be licensed as a producer
Insurance advertisements in a local newspaper are regulated by? ---
correct answer ---Department of Banking and Insurance
Johan the producer charged a fee to a sales prospect for analyzing
insurance coverages. According to NJ law, a reasonable relationship
,must exist between the fee and the --- correct answer ---Substance
of the services performed
What is the free-look period of a Medicare Supplement policy? ---
correct answer ---30 days
Which of the following is an example of defamation? --- correct
answer ---Using derogatory about an insurance company's financial
condition
All of the following are included as part of a contract in the entire
contract provision EXCEPT the --- correct answer ---changes made
by the producer
A health insurance policy that allows an insurer to change the
policy owner's premiums, but NOT cancel the policy is called a(n) --
- correct answer ---guaranteed renewable policy
Richard owns an insurance policy that is renewable only at the
option of the insurance company. His policy is considered to be ---
correct answer ---Optionally renewable
According to the principle of Utmost Good Faith, the insured will
answer questions on the application to the best of their knowledge
, and pay the required premium, while the insurer will deal fairly
with the insured and it's --- correct answer ---promise made
An insurer must furnish to a claimant forms for filling proof of loss
within ____ days upon receiving a notice of claim --- correct
answer ---15 days
A person who is a nonsmoker, of average weight, and in excellent
health would most likely be in which risk classification? --- correct
answer ---Preferred
An agent is an individual that represents whom? --- correct answer
---Licensed producer who has written contract to represent an
insurer
Disability Income plans which require that the insurer can NEVER
change or alter premium rates are usually considered --- correct
answer ---Noncancellable
In NJ, group health insurance may be offered to all of these groups
EXCEPT --- correct answer ---College seminar participants
Jerry voluntarily terminated his producer's license. If he changes
his mind, his license may be reinstate during the same license