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Exam (elaborations)

Health Final Exam - NJ Accident and Health

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Health Final Exam - NJ Accident and Health

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  • June 19, 2024
  • 12
  • 2023/2024
  • Exam (elaborations)
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Health Final Exam - NJ Accident and
Health
The Commissioner must approve - correct answer-Continuing education courses

Employer sponsored group health insurance provides coverage for which of the following?

Self-inflicted injuries
cosmetic surgery
custodial care
alcoholism - correct answer-alcoholism

A Medicare supplement policy can be cancelled by the insurer for - correct
answer-Nonpayment

Which entity is responsible for regulating insurance advertising in NJ? - correct 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 - correct answer-Brokers and consultants

Written notice for a health claim must be given to the insurer ___ days after the occurrence
of the loss. - correct 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 - correct
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 -
correct answer-The policy must be issued regardless of health status

In what form do disability income policies typically pay benefits? - correct answer-Periodic
income

What is considered to be the primary reason for buying life insurance? - correct
answer-Provide death benefits

, A newborn is required to be covered for ____ days from the moment of birth - correct
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 - correct 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 - correct
answer-Doctor cannot charge more than Medicare's scheduled coverage

What is issued to each employee with an employer health plan? - correct answer-Certificate

What is the tax liability for employer contributions in Health Savings Accounts (HSA's)? -
correct 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 - correct answer-National Association of
Insurance Underwriters

In NJ, health insurance advertisements are required to contain the - correct
answer-insurance company's name

Replacement regulation is designed to protect the interests of - correct answer-Policyowners

The Commissioner of Insurance is appointed by - correct 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? -
correct 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 - correct answer-Physical therapy

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