NJ Health and Accident Insurance Practice Exam (NEW Updated Version 2025) Comprehensive Exam-Style Questions with Correct Answers and Detailed Rationales for New Jersey Insurance Licensing Candidates

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Health Final Exam - NJ Accident and Health (NEW UPDATED VERSION)
LATEST ACTUAL EXAM QUESTIONS AND CORRECT ANSWERS (VERIFIED
QUESTIONS AND ANSWERS) | GUARANTEED PASS A+ UPDATED THIS YEAR




The Commissioner must approve - CORRECT ANSWER Continuing education
courses



QUESTION : Employer sponsored group health insurance provides coverage for which of
the following?



Self-inflicted injuries

cosmetic surgery

custodial care

alcoholism - CORRECT ANSWER alcoholism



QUESTION : A Medicare supplement policy can be cancelled by the insurer for -
CORRECT ANSWER Nonpayment



QUESTION : Which entity is responsible for regulating insurance advertising in NJ? -
CORRECT ANSWER New Jersey Department of Banking and Insurance



QUESTION : Which of the following are retained at the expense of an insurance buyer to
give advice on insurance needed by the buyer?




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Brokers and consultants

Insurance prospectors

Third-party adminstrators

Agents - CORRECT ANSWER Brokers and consultants



QUESTION : Written notice for a health claim must be given to the insurer ___ days after
the occurrence of the loss. - CORRECT ANSWER 20



QUESTION : 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 -
CORRECT ANSWER d) The insured suffered an injury as an innocent bystander
during a bank robbery



QUESTION : When a Medicare supplement policy is purchased during the open
enrollment period - CORRECT ANSWER The policy must be issued regardless of
health status



QUESTION : In what form do disability income policies typically pay benefits? -
CORRECT ANSWER Periodic income



QUESTION : What is considered to be the primary reason for buying life insurance? -
CORRECT ANSWER Provide death benefits



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QUESTION : A newborn is required to be covered for ____ days from the moment of birth
- CORRECT ANSWER 30



QUESTION : 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



QUESTION : 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 - CORRECT
ANSWER Doctor cannot charge more than Medicare's scheduled coverage



QUESTION : What is issued to each employee with an employer health plan? -
CORRECT ANSWER Certificate



QUESTION : What is the tax liability for employer contributions in Health Savings
Accounts (HSA's)? - CORRECT ANSWER No tax payment needed



QUESTION : 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)


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Inspection reports

National Association of Insurance Underwriters - CORRECT ANSWER National
Association of Insurance Underwriters



QUESTION : In NJ, health insurance advertisements are required to contain the -
CORRECT ANSWER insurance company's name



QUESTION : Replacement regulation is designed to protect the interests of - CORRECT
ANSWER Policyowners



QUESTION : The Commissioner of Insurance is appointed by - CORRECT ANSWER
The governor



QUESTION : 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? - CORRECT ANSWER Medicare supplement plan F



QUESTION : Which of the following is NOT a common exclusion for a medical expense
policy?



Physical therapy

Act of war

on the job injury

self inflicted injury - CORRECT ANSWER Physical therapy




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