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NJ Health Insurance Exam Questions and Answers 2024( A+ GRADED 100% VERIFIED).
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NJ Health Insurance Exam Questions and Answers 2024( A+ GRADED 100% VERIFIED).
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NJ Health InsuranceThe Legal actions provisions of an accident and sickness policy require - ANS
An insured wait at least 60 days after the submission of proof of loss before
starting a lawsuit
Pre-existing conditions are deferred to during this provision - ANS Time limit on
certain defenses
Usual reasonable and customary fee - ANS Fee charged when medical expense
policies do not state specific benefit amounts, but instead base payments upon
charges for like services in the same geographical area
Insured's disability income policy defines total disability as "the insured's
inability to perform duties of any occupation. This definition is known as - ANS
"any occupation" and is more restrictive than other definitions
Conversion provision - ANS The right of an employee to exchange his group
insurance for an individual policy within 31 days from the termination of
employment
The master policy owner - ANS Person who has the responsibility to apply for
coverage, provide information about the group, and maintain the policy and pay
the premiums
Waiver of Premium - ANS Endorsement attached to health insurance policy
indicating the insurer will allow the policy to continue in force without further
premiums if the insured is totally and permanently disabled.
Non-contributory group plan - ANS 100% of eligible employees must be covered
For employees to obtain group coverage without evidence of insurability, they
must - ANS Enroll within a specific eligibility period
People eligible for medicare - ANS People age 65 or older who are eligible for
social security
, People age 65 or older not eligible for social security, but willing to pay a monthly
premium
People at any age who have been entitled to disability benefits for 24 months
Primary support for Medicare funded by - ANS Social Security payroll taxes
Medicare Part B - Medical Insurance - ANS Part of medicare that requires
premium payment by most eligible participants
All Medicare Supplement policies (Medigap) must - ANS have the same core
benefits
Benefits provided under Part A of Medicare - ANS Inpatient hospitality care
Skilled nursing facility care
Hospice care
Medicare supplement policies - ANS Designed to pay at least some of the health
care costs that medicare will not pay
Medicaid - ANS Provides medical benefits for certain low-income people, the
disabled, and for families with dependent children
Requirements for payment of Social Security disability benefits - ANS Total and
permanent disability for at least 5 months
Fully insured and disability insured
Expected disability of 12 months or longer or ended in death
NJ Temporary Disability Law - ANS Provides for employers and employees to
contribute to a fund through payroll taxes
The social Security disability benefit payable - ANS The amount the recipient
would receive at retirement
Dependent of quarters of coverage
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