NJ Health and Accident Questions and
Answers 100% Pass
The Commissioner must approve - ANSWER Continuing education courses
Employer sponsored group health insurance provides coverage for which of the following?
Self-inflicted injuries
cosmetic surgery
custodial care
alcoholism - ANSWER alcoholism
A Medicare supplement policy can be cancelled by the insurer for - ANSWER Nonpayment
Which entity is responsible for regulating insurance advertising in NJ? - ANSWER 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 - ANSWER Brokers and consultants
Written notice for a health claim must be given to the insurer ___ days after the occurrence
of the loss. - ANSWER 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 - ANSWER
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 -
ANSWER The policy must be issued regardless of health status
In what form do disability income policies typically pay benefits? - ANSWER Periodic
income
, What is considered to be the primary reason for buying life insurance? - ANSWER Provide
death benefits
A newborn is required to be covered for ____ days from the moment of birth - ANSWER 30
Once an accident and health insurance policy has been in force for ___ year(s), the policy
may NOT be contested by the insurer - ANSWER 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 - ANSWER Doctor
cannot charge more than Medicare's scheduled coverage
What is issued to each employee with an employer health plan? - ANSWER Certificate
What is the tax liability for employer contributions in Health Savings Accounts (HSA's)? -
ANSWER 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 - ANSWER National Association of
Insurance Underwriters
In NJ, health insurance advertisements are required to contain the - ANSWER insurance
company's name
Replacement regulation is designed to protect the interests of - ANSWER Policyowners
The Commissioner of Insurance is appointed by - ANSWER 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? -
ANSWER Medicare supplement plan F
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 - ANSWER Physical therapy
Twisting is best defined as - ANSWER using misrepresentation to induce an insured person
to terminate an existing policy and purchase a new policy
The reinstatement provision in a health insurance policy is - ANSWER Mandatory
A producer has recently died and leaves behind a spouse. In order for the producer's
insurance business to continue, the Department of Banking and Insurance may issue to the
producer's spouse a(n) - ANSWER temporary insurance license
Pierre the producer receives a premium for an individual health insurance policy. Pierre
MUST remit the premium to his insurer within ____ business days of receipt - ANSWER 7
Nina just passed her NJ insurance licensing examination. She is REQUIRED to apply for a
producer's license within ____ months - ANSWER 12
Which of the following MUST contain a "statement of policy cost and benefit information"?
- ANSWER Policy Summary
The department of banking and insurance can make information pertaining to a producers
license available through - ANSWER Certificate of License Status Report
Intentional withholding of material facts that would affect an insurance policy's validity is
called a(n) - ANSWER Concealment
Under the NJ Continuance of Benefits law, notice to extend coverage is required within how
many days of a qualifying event? - ANSWER 30
Which of the following does Medicare Part D cover?
Intensive care coverage
Doctor visits
Prescription drugs
Hospital coverage - ANSWER Prescription drugs
Which of these gaps in Medicare coverage is addressed with Medicare Supplemental
Insurance? - ANSWER Medicare in-hospital deductible
Under group health insurance, a certificate of coverage is issued to the - ANSWER employee
, Claims payable to a Disability Income insured, even when the insured can continue to work,
are the result of a - ANSWER Presumptive disability
A dread disease policy is considered to be a type of - ANSWER Limited health insurance
policy
How often must an insurance producer's license in NJ be renewed? - ANSWER every 2
years
Which type of disability would be less than total impairment and equal to permanent
impairment? - ANSWER Permanent partial disability
An insurance consultant is BEST defined as a(n) - ANSWER Producer who charges fees for
advice
Kathy pays a monthly premium on her health insurance policy. How long is her grace
period? - ANSWER 10 days
Susan is insured through her Group Health Insurance plan and changed her coverage to an
individual plan with the same insurer after her employment was terminated. This change is
called a(n)
crossover
conversion
exchange
extension of benefits - ANSWER Conversion
What amount will be paid under a policy where the insured misstated his/her age? -
ANSWER An amount the premium would have purchased at the correct age
The IRS allows a taxpayer to deduct medical expenses that exceed 7.5% of their adjusted
gross income. Which of the following is considered a tax deductible medical expense under
this rule? - ANSWER Long term care insurance premiums
Which of these may Not be used in a health insurance advertisement?
celebrity endorsement
statement that highlights coverage amounts
paid testimonial
insurance company's trademark instead of the company's actual name - ANSWER insurance
company's trademark instead of the company's actual name
Answers 100% Pass
The Commissioner must approve - ANSWER Continuing education courses
Employer sponsored group health insurance provides coverage for which of the following?
Self-inflicted injuries
cosmetic surgery
custodial care
alcoholism - ANSWER alcoholism
A Medicare supplement policy can be cancelled by the insurer for - ANSWER Nonpayment
Which entity is responsible for regulating insurance advertising in NJ? - ANSWER 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 - ANSWER Brokers and consultants
Written notice for a health claim must be given to the insurer ___ days after the occurrence
of the loss. - ANSWER 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 - ANSWER
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 -
ANSWER The policy must be issued regardless of health status
In what form do disability income policies typically pay benefits? - ANSWER Periodic
income
, What is considered to be the primary reason for buying life insurance? - ANSWER Provide
death benefits
A newborn is required to be covered for ____ days from the moment of birth - ANSWER 30
Once an accident and health insurance policy has been in force for ___ year(s), the policy
may NOT be contested by the insurer - ANSWER 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 - ANSWER Doctor
cannot charge more than Medicare's scheduled coverage
What is issued to each employee with an employer health plan? - ANSWER Certificate
What is the tax liability for employer contributions in Health Savings Accounts (HSA's)? -
ANSWER 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 - ANSWER National Association of
Insurance Underwriters
In NJ, health insurance advertisements are required to contain the - ANSWER insurance
company's name
Replacement regulation is designed to protect the interests of - ANSWER Policyowners
The Commissioner of Insurance is appointed by - ANSWER 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? -
ANSWER Medicare supplement plan F
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 - ANSWER Physical therapy
Twisting is best defined as - ANSWER using misrepresentation to induce an insured person
to terminate an existing policy and purchase a new policy
The reinstatement provision in a health insurance policy is - ANSWER Mandatory
A producer has recently died and leaves behind a spouse. In order for the producer's
insurance business to continue, the Department of Banking and Insurance may issue to the
producer's spouse a(n) - ANSWER temporary insurance license
Pierre the producer receives a premium for an individual health insurance policy. Pierre
MUST remit the premium to his insurer within ____ business days of receipt - ANSWER 7
Nina just passed her NJ insurance licensing examination. She is REQUIRED to apply for a
producer's license within ____ months - ANSWER 12
Which of the following MUST contain a "statement of policy cost and benefit information"?
- ANSWER Policy Summary
The department of banking and insurance can make information pertaining to a producers
license available through - ANSWER Certificate of License Status Report
Intentional withholding of material facts that would affect an insurance policy's validity is
called a(n) - ANSWER Concealment
Under the NJ Continuance of Benefits law, notice to extend coverage is required within how
many days of a qualifying event? - ANSWER 30
Which of the following does Medicare Part D cover?
Intensive care coverage
Doctor visits
Prescription drugs
Hospital coverage - ANSWER Prescription drugs
Which of these gaps in Medicare coverage is addressed with Medicare Supplemental
Insurance? - ANSWER Medicare in-hospital deductible
Under group health insurance, a certificate of coverage is issued to the - ANSWER employee
, Claims payable to a Disability Income insured, even when the insured can continue to work,
are the result of a - ANSWER Presumptive disability
A dread disease policy is considered to be a type of - ANSWER Limited health insurance
policy
How often must an insurance producer's license in NJ be renewed? - ANSWER every 2
years
Which type of disability would be less than total impairment and equal to permanent
impairment? - ANSWER Permanent partial disability
An insurance consultant is BEST defined as a(n) - ANSWER Producer who charges fees for
advice
Kathy pays a monthly premium on her health insurance policy. How long is her grace
period? - ANSWER 10 days
Susan is insured through her Group Health Insurance plan and changed her coverage to an
individual plan with the same insurer after her employment was terminated. This change is
called a(n)
crossover
conversion
exchange
extension of benefits - ANSWER Conversion
What amount will be paid under a policy where the insured misstated his/her age? -
ANSWER An amount the premium would have purchased at the correct age
The IRS allows a taxpayer to deduct medical expenses that exceed 7.5% of their adjusted
gross income. Which of the following is considered a tax deductible medical expense under
this rule? - ANSWER Long term care insurance premiums
Which of these may Not be used in a health insurance advertisement?
celebrity endorsement
statement that highlights coverage amounts
paid testimonial
insurance company's trademark instead of the company's actual name - ANSWER insurance
company's trademark instead of the company's actual name
