NJ Health and Accident Questions and Answers 100% Pass Guarantee 2024
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Course
NJ Health and Accident
Institution
NJ Health And Accident
Life income joint and survivor settlement option guarantees...
Income for 2 or more recipents
A participating insurance policy may do which of the following:...
Pay dividends to the policy owner
What is TRUE about the cash surrender nonforfeiture option?
Funds exceeding the premiums paid are t...
NJ Health and Accident Questions and Answers 100% Pass
Guarantee 2024
In what form do disability income policies typically pay benefits - Answer- Periodic income
The Mandatory health policy provision states that the policy, including endorsements and
attached papers, constitutes - Answer- The entire insurance contract between the parties
The entire contract includes the actual policy and the - Answer- application
employer sponsored group health insurance provides coverage for which of the following -
Answer- Alcoholism
The term which describes the fact that both parties of a contract may not receive the same value
is referred to as - Answer- Aleatory
Tom has a home health care benefit and is confined to his home. Which of these is NOT
typically covered - Answer- Full-time nursing care
A Medicare Supplement policy can be cancelled by the insurer for - Answer- Nonpayment
Credit Accident and Health plans are designed to - Answer- help pay off existing loans during
periods of disability
A payment system for health care in which the provider is paid for each service given is called -
Answer- fee-for-service
An insurance company ONLY pay a sales commission to - Answer- individuals licensed by the
state
,Ken is a producer who has obtained Consumer Information Reports under false pretenses. Under
the Fair Credit Reporting Act, what is the maximum penalty that may be imposed on Ken? -
Answer- $5000 and 1 year imprisonment
A closed network plan offers a primary physician copay of $25. If a subscriber chooses a
primary care physician outside of the network, the subscriber will likely pay - Answer- 100% of
the billed amount
What is the maximum fine for a producer violating an NJ insurance law for the first time? -
Answer- $5000
A licensed producer is required to file notice to any changes of address within how many days -
Answer- 30 days
Jonas has disability insurance through his employer. The employer pays 75% of the premium,
and Jonas pays the other 25%. What is Jonas's tax liability for any benefits paid from the
disability plan? - Answer- Taxes must be paid on 75% of the benefits received
After an insured gives notice of loss, what must he/she do if the insurer does not furnish forms? -
Answer- File written proof of loss
Which of the following is an example of the insured's consideration? - Answer- A paid premium
A(n) _______ insurance company is one that was formed under the laws of a state other than NJ
- Answer- Foreign
Kathy pays a monthly premium on her health insurance policy. How long is her grace period? -
Answer- 10 days
Insurance licenses are intended to be issued for the purpose of authorizing the transaction of
business with members of the general public and not primarily allowing someone to benefit from
commissions on business that insurers their personal interest. The description of which of the
following? - Answer- Controlled business
,A master contract and certified coverage can be found in which type of policy? - Answer- Group
Medicaid is a government-funded program designed to provide health care to - Answer- poor
people
Which type of long-term care benefit would be most appropriate for a stroke victim who requires
speech therapy administered at her home? - Answer- Home Health Care
What does the Consolidated Omnibus Budget Reconciliation Act (COBRA) of 1985 allow an
employee to do? - Answer- In the event of employment termination, group health insurance can
be kept if the employee pays the premiums
Replacement regulation is designed to protect the interests of - Answer- Policy owners
Continued coverage under COBRA would be provided to all of the following except? - Answer-
a covered employee is terminated for gross misconduct
A health insurer must be provided with written proof of loss ______ days after the date of loss -
Answer- 90 days
All of the following are factors would affect a health insurance policies premium rate Except -
Answer- Residential address of the insured
Which of the following is NOT a required provision in an accident and health insurance policy? -
Answer- Change of occupation (considered optional provision)
Within how many days must a producer notify the Department of Banking and Insurance of a
change in address? - Answer- 30 days
When comparing an HMO, to a PPO, the PPO - Answer- provides a greater choice of providers
, Under the Consolidated Omnibus Budget Reconciliation Act (COBRA), a terminated employee's
benefits must - Answer- be the same and the premium cannot exceed 102%
An agent is required to keep replacement forms on file for at LEAST ______ years. - Answer- 5
years
An insurer has the right to recover a payment made to the insured from the negligent party.
These rights are called - Answer- Subrogation
All advertisements for health insurance shall make clear the identity of the - Answer- insurer
Bill requires some nursing care and supervision but NOT full-time care. Which of these nursing
home options would best serve him? - Answer- Assisted living
How many employees must an employer have for a terminated employee to be eligible for
COBRA? - Answer- 20
An agent has committed an insurance crime that violates US CODE 1033 (interstate commerce).
Who would be responsible for the prosecution of this crime? - Answer- US Attorney General
The time limit for filing claim disputes is addressed in which provision of an accident and health
policy? - Answer- Legal actions
What is the process for a producer voluntarily terminating his/her license? - Answer- Returning
his/her license to the Banking and Insurance Department
Under the Health Insurance Portability and Accountability Act (HIPAA), the employee's new
Group Health Plan will verify Creditable Coverage so that the - Answer- employee's waiting
period for coverage of a preexisting condition can be reduced under the new employer's health
plan
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