Health Final Exam - NJ Accident and
Health
The Commissioner must approve - ANS Continuing education courses
Employer sponsored group health insurance provides coverage for which of the following?
Self-inflicted injuries
cosmetic surgery
custodial care
alcoholism - ANS alcoholism
A Medicare supplement policy can be cancelled by the insurer for - ANS Nonpayment
Which entity is responsible for regulating insurance advertising in NJ? - ANS New Jersey
Department of Banking and Insurance
Which of the following are retained at the expense of an insurance buyer to give advice on
insurance needed by the buyer?
Brokers and consultants
Insurance prospectors
Third-party adminstrators
Agents - ANS Brokers and consultants
Written notice for a health claim must be given to the insurer ___ days after the occurrence of
the loss. - ANS 20
In which of the following situations would the insurer be liable for a loss?
a) The insured skipped a payment beyond the 31 day grace period
b) The insured was injured while participating in an illegal occupation
c) The insured was given a notice of cancellation from the insurer
d) The insured suffered an injury as an innocent bystander during a bank robbery - ANS d) The
insured suffered an injury as an innocent bystander during a bank robbery
When a Medicare supplement policy is purchased during the open enrollment period - ANS The
policy must be issued regardless of health status
, In what form do disability income policies typically pay benefits? - ANS Periodic income
What is considered to be the primary reason for buying life insurance? - ANS Provide death
benefits
A newborn is required to be covered for ____ days from the moment of birth - ANS 30
Once an accident and health insurance policy has been in force for ___ year(s), the policy may
NOT be contested by the insurer - ANS 2
A doctor who accepts Medicare assignment agrees to which of the following
- Doctor may charge up to a maximum of 15% more than Medicare pays for the service
- Doctor is not bound by Medicare's limitations on charges
- Doctor cannot charge more than Medicare's scheduled coverage
- Doctor bills the Medicare beneficiary directly for services performed - ANS Doctor cannot
charge more than Medicare's scheduled coverage
What is issued to each employee with an employer health plan? - ANS Certificate
What is the tax liability for employer contributions in Health Savings Accounts (HSA's)? - ANS
No tax payment needed
All of these are considered sources of information that can assist an underwriter in determining
whether or not to accept a risk EXCEPT
Agent's report
Medical Information Bureau (MIB)
Inspection reports
National Association of Insurance Underwriters - ANS National Association of Insurance
Underwriters
In NJ, health insurance advertisements are required to contain the - ANS insurance company's
name
Replacement regulation is designed to protect the interests of - ANS Policyowners
The Commissioner of Insurance is appointed by - ANS The governor
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? - ANS Medicare
supplement plan F
Which of the following is NOT a common exclusion for a medical expense policy?
Health
The Commissioner must approve - ANS Continuing education courses
Employer sponsored group health insurance provides coverage for which of the following?
Self-inflicted injuries
cosmetic surgery
custodial care
alcoholism - ANS alcoholism
A Medicare supplement policy can be cancelled by the insurer for - ANS Nonpayment
Which entity is responsible for regulating insurance advertising in NJ? - ANS New Jersey
Department of Banking and Insurance
Which of the following are retained at the expense of an insurance buyer to give advice on
insurance needed by the buyer?
Brokers and consultants
Insurance prospectors
Third-party adminstrators
Agents - ANS Brokers and consultants
Written notice for a health claim must be given to the insurer ___ days after the occurrence of
the loss. - ANS 20
In which of the following situations would the insurer be liable for a loss?
a) The insured skipped a payment beyond the 31 day grace period
b) The insured was injured while participating in an illegal occupation
c) The insured was given a notice of cancellation from the insurer
d) The insured suffered an injury as an innocent bystander during a bank robbery - ANS d) The
insured suffered an injury as an innocent bystander during a bank robbery
When a Medicare supplement policy is purchased during the open enrollment period - ANS The
policy must be issued regardless of health status
, In what form do disability income policies typically pay benefits? - ANS Periodic income
What is considered to be the primary reason for buying life insurance? - ANS Provide death
benefits
A newborn is required to be covered for ____ days from the moment of birth - ANS 30
Once an accident and health insurance policy has been in force for ___ year(s), the policy may
NOT be contested by the insurer - ANS 2
A doctor who accepts Medicare assignment agrees to which of the following
- Doctor may charge up to a maximum of 15% more than Medicare pays for the service
- Doctor is not bound by Medicare's limitations on charges
- Doctor cannot charge more than Medicare's scheduled coverage
- Doctor bills the Medicare beneficiary directly for services performed - ANS Doctor cannot
charge more than Medicare's scheduled coverage
What is issued to each employee with an employer health plan? - ANS Certificate
What is the tax liability for employer contributions in Health Savings Accounts (HSA's)? - ANS
No tax payment needed
All of these are considered sources of information that can assist an underwriter in determining
whether or not to accept a risk EXCEPT
Agent's report
Medical Information Bureau (MIB)
Inspection reports
National Association of Insurance Underwriters - ANS National Association of Insurance
Underwriters
In NJ, health insurance advertisements are required to contain the - ANS insurance company's
name
Replacement regulation is designed to protect the interests of - ANS Policyowners
The Commissioner of Insurance is appointed by - ANS The governor
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? - ANS Medicare
supplement plan F
Which of the following is NOT a common exclusion for a medical expense policy?
