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NJ Health and accidental Practice final exam excel solutions
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NJ Health and accidental Practice finalexam excel solutions
A long-term care policy typically provides all of the following levels of care EXCEPT
Skilled care
Intermediate care
Acute care
Custodial care - correct answer-acute care
All of the following are included as part of a contract in the entire contract provision EXCEPT
the:
Riders
application
Changes made by the producer - correct answer-changes made by the producer
An insurance company may ONLY pay a sales commission to:
Individuals who are residents of this state for at least 5 years
Individuals who are registered with the NAIC
Individuals licensed by the state
Individuals who are gainfully employment by that insurance company - correct
answer-Individuals licensed by the state
The law established insurance transactions should be regulated by the states is called the
McCarran-Ferguson Act
Mccain-Feingold act
Fair credit Reporting Act
Paul vs Virginia - correct answer-McCarren-Ferguson Act
In a group medical expense health insurance plan, coverage for alcoholism is treated as: -
correct answer-Any other illness, sickness or disease
A producer must notify the Commissioner within ___ days of a felony conviction.
15
30
45
60 - correct answer-30
The purpose of Medicare Supplement Insurance is to address gaps in Medicare coverage,
which can include?
Medicare in hospital deductible
replacing HMO coverage
Covering chiropractic treatment
Treatment provided in a government hospital - correct answer-Medicare in-hospital
deductible
,in in New Jersey, health insurance advertisements are required to contain the
Insurance company's trademark
Insurance company's name
Insurance company's AM Best rating
Insurance company's current standing with the better business Bureau - correct
answer-Insurance company's name
States that have "no loss no gain" laws require a replacing policy to....
Keep the same type if coverage as the policy it replaces
Not change a different premium from the policy if replaces
pay for half of any ongoing claims under the policy it replaces
Pay for ongoing claims under the policy it replaces - correct answer-Pay for ongoing claims
under the policy it replaces
Which of the following is NOT a required provision in an accident and health insurance
policy?
Legal actions
grace period
Change of occupation
reinstatement - correct answer-change of occupation
In group health care, what is the purpose of the coordination of benefits provision?
Determines where as insured goes to receive treatment
Determines what is paid by the primary and secondary insurers in the event of a claim
Ensures that a health provider receives the proper benefit amount owed
Determines which parent plan covers a department child - correct answer-Determines what
is paid by the primary and secondary insurers in the event of a claim
An accident and health insurer has just received written proof of loss from one of its
insureds. The insured must now wait 60 days before
Submitting another claim
bringing legal actions against the insurer
the insurer will pay the claim
purchasing more insurance from this insurer - correct answer-bringing legal action against
the insurer
A temporary producers license may be issued for up to _________ days.
30 days
60 days
180 days
12 months - correct answer-180
, Which of the following is typically Not eligible for coverage in group health policy?
Full time employee
Temporary employee
Business owner
partner in a partnership - correct answer-Temporary employee 29
Someone needing custodial care at home would require which type of coverage?
Major medical
Disability
Long term care
Medicaid - correct answer-long term care 30
a buyers guide and policy summary
Must be delivered with or prior to policy delivery
• must be delivered with or prior to policy delivery
• is not required in the state of New Jersey
• must be delivered within 30 days of policy delivery
• is only required when a binding receipt is issued - correct answer-must be delivered with or
prior to policy delivery
Disability Income plans which require that the insurer can NEVER change or after premium
rates are usually considered?
• Guaranteed Renewable
• Optionally Renewable
•Conditionally Renewable
• Noncancellable - correct answer-Noncanellable
The commissioner issues a subpoena to a producer. The producer Decides not to respond.
Which course of action must be taken by the commissioner?
• Commissioner must terminate the producer's appointment
• Commissioner must reissue another subpoena
• Commissioner may impose an administrative penalty
• Commissioner may incarcerate the producer - correct answer-Commissioner may impose
an administrative penalty
After an insured gives notice of loss, what must he/she do if the insurer does not furnish
forms?
• File a lawsuit
• Contact the insurer again requesting forms
Nothing
• File written proof of loss - correct answer-file written proof of loss
Bryce purchased a disability income policy with a rider that guarantees him the option of
purchasing additional amounts of coverage at predetermined times without requiring to
provide evidence of insurability. what kind of rider is this?
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