Page 1 of 98
NORTH CAROLINA HEALTH INSURANCE LICENSE TEST
EXAM LATEST UPDATE THIS YEAR ALL 400 QUESTIONS
AND CORRECT DETAILED SOLUTIONS ALREADY GRADED
JUST RELEASED
Question: Which of the following is true regarding inpatient hospital care for HMO members?
A. Inpatient hospital care is not part of HMO services
B. Care can be provided outside of the service area
C. Can can only be provided in the service area
D. Services for treatment of mental disorders are unlimited - CORRECT ANSWER✔✔B.
Question: When Linda suffered a broken hip, she notified her agent, in writing, within 12 days of
the loss. However, her agent did not notify the insurance company until 60 days after the loss.
Which of the following statements correctly explains how this claim would be handled?
A. The insurer is considered to be notified since the notification to agent equals notification to
the insurer
B. The insurer may delay the payment of this claim for up to 6 months
C. The insurer may settle this claim for less than it otherwise would have had the notification
been provided in a timely manner
, Page 2 of 98
D. The insurer may deny the claim since it was not notified within the required 20 day time
frame - CORRECT ANSWER✔✔A.
Question: While repairing the roof of his house an insured accidentally falls off and breaks his
arm and sustains a head injury that results in total blindness of both eyes. His policy contains an
Accidental Death & Dismemberment Rider. What is the extent of benefits that he will receive?
A. Reciprocal Amount
B. Principal Sum
C. Capital Sum
D. 50% of the Principal - CORRECT ANSWER✔✔B.
Question: As it pertains to group health insurance, the continuation provision stipulates that
A. Terminated employees may convert to an individual policy only upon proof of insurability
B. Group coverage must be extended for terminated employees up to a certain period of time at
the employers expense
C. Group coverage must be extended for terminated employees up to a certain period of time at
the employees expense
D. Retiring employees must be allowed to convert their group coverage to individual policies -
CORRECT ANSWER✔✔C.
, Page 3 of 98
Question: All of the following apply to short term disability plans EXCEPT
A. Individual plans can provide benefit periods of up to 2 years
B. A benefit period of 26 weeks is most common for group plans
C. Both group and individual plans are renewable
D. Group plans can provide benefit periods of up to 52 weeks - CORRECT ANSWER✔✔C.
Question: Which describes the features of a comprehensive major medical policy?
A. There is no coinsurance
B. Basic medical expense benefits are provided in single package
C. The deductible is always expressed as a deferred amount
D. It is the same as major medical insurance - CORRECT ANSWER✔✔B.
Question: If an insurer accepts premium payments by credit card, who is responsible for paying
the fees charged by a credit card company?
A. Credit card company
B. Insurer accepting payment
C. Policy owners, as part of premium
D. Insured - CORRECT ANSWER✔✔B.
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Question: When a disabled dependent child reaches the age limit for coverage, how long does
the policyowner have to provide proof of dependency in order for the dependent to remain
covered under the policy?
A. 15 days
B. 31 days
C. 60 days
D. 10 days - CORRECT ANSWER✔✔B.
Question: If a licensee is convicted of a criminal violation , the licensees insurance license is?
A. Suspended after hearing
B. Automatically suspended
C. Automatically revoked
D. Not affected - CORRECT ANSWER✔✔B.
Question: All of the following are differences between Individual and group health insurance
EXCEPT
A. In individual policies, the individual selects coverage options, while in a group plan all
employees are covered for the same coverage which is chosen by employer
B. Individual coverage can be written on an occupation or no occupational basis
NORTH CAROLINA HEALTH INSURANCE LICENSE TEST
EXAM LATEST UPDATE THIS YEAR ALL 400 QUESTIONS
AND CORRECT DETAILED SOLUTIONS ALREADY GRADED
JUST RELEASED
Question: Which of the following is true regarding inpatient hospital care for HMO members?
A. Inpatient hospital care is not part of HMO services
B. Care can be provided outside of the service area
C. Can can only be provided in the service area
D. Services for treatment of mental disorders are unlimited - CORRECT ANSWER✔✔B.
Question: When Linda suffered a broken hip, she notified her agent, in writing, within 12 days of
the loss. However, her agent did not notify the insurance company until 60 days after the loss.
Which of the following statements correctly explains how this claim would be handled?
A. The insurer is considered to be notified since the notification to agent equals notification to
the insurer
B. The insurer may delay the payment of this claim for up to 6 months
C. The insurer may settle this claim for less than it otherwise would have had the notification
been provided in a timely manner
, Page 2 of 98
D. The insurer may deny the claim since it was not notified within the required 20 day time
frame - CORRECT ANSWER✔✔A.
Question: While repairing the roof of his house an insured accidentally falls off and breaks his
arm and sustains a head injury that results in total blindness of both eyes. His policy contains an
Accidental Death & Dismemberment Rider. What is the extent of benefits that he will receive?
A. Reciprocal Amount
B. Principal Sum
C. Capital Sum
D. 50% of the Principal - CORRECT ANSWER✔✔B.
Question: As it pertains to group health insurance, the continuation provision stipulates that
A. Terminated employees may convert to an individual policy only upon proof of insurability
B. Group coverage must be extended for terminated employees up to a certain period of time at
the employers expense
C. Group coverage must be extended for terminated employees up to a certain period of time at
the employees expense
D. Retiring employees must be allowed to convert their group coverage to individual policies -
CORRECT ANSWER✔✔C.
, Page 3 of 98
Question: All of the following apply to short term disability plans EXCEPT
A. Individual plans can provide benefit periods of up to 2 years
B. A benefit period of 26 weeks is most common for group plans
C. Both group and individual plans are renewable
D. Group plans can provide benefit periods of up to 52 weeks - CORRECT ANSWER✔✔C.
Question: Which describes the features of a comprehensive major medical policy?
A. There is no coinsurance
B. Basic medical expense benefits are provided in single package
C. The deductible is always expressed as a deferred amount
D. It is the same as major medical insurance - CORRECT ANSWER✔✔B.
Question: If an insurer accepts premium payments by credit card, who is responsible for paying
the fees charged by a credit card company?
A. Credit card company
B. Insurer accepting payment
C. Policy owners, as part of premium
D. Insured - CORRECT ANSWER✔✔B.
, Page 4 of 98
Question: When a disabled dependent child reaches the age limit for coverage, how long does
the policyowner have to provide proof of dependency in order for the dependent to remain
covered under the policy?
A. 15 days
B. 31 days
C. 60 days
D. 10 days - CORRECT ANSWER✔✔B.
Question: If a licensee is convicted of a criminal violation , the licensees insurance license is?
A. Suspended after hearing
B. Automatically suspended
C. Automatically revoked
D. Not affected - CORRECT ANSWER✔✔B.
Question: All of the following are differences between Individual and group health insurance
EXCEPT
A. In individual policies, the individual selects coverage options, while in a group plan all
employees are covered for the same coverage which is chosen by employer
B. Individual coverage can be written on an occupation or no occupational basis
