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NJ Health and Accident TEST FINAL EXAM AND PRACTICE
EXAM 20262027 BANK 2 VERSIONS QUESTIONS WITH
DETAILED VERIFIED ANSWERS EXAM QUESTIONS WILL
COME FROM HERE (100% CORRECT ANSWERS A+ GRADED
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 - ANSWERS--100% of the billed amount
A health insurance policy that allows an insurer to change the policy
owner's premiums, but NOT cancel the policy is called a(n) - ANSWERS--
guaranteed renewable policy
A health insurance policy where the insurer has the right to terminate
the policy for reasons other than the insured's health is called -
ANSWERS--conditionally renewable
A health insurance policy will typically cover - ANSWERS--Preventative
health services
A health insurer must be provided with written proof of loss ______
days after the date of loss - ANSWERS--90 days
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A licensed producer is required to file notice to any changes of address
within how many days - ANSWERS--30 days
A master contract and certified coverage can be found in which type of
policy? - ANSWERS--Group
A medical provider that accepts Medicare Assignment must -
ANSWERS--accept payment based upon a defined Medicare schedule as
payment in full
A Medicare Supplement policy can be cancelled by the insurer for -
ANSWERS--Nonpayment
A medicare supplement policy must NOT contain benefits which -
ANSWERS--duplicate Medicare benefits
A newborn is required to be covered for _____ days from the moment
of birth - ANSWERS--30 days
A payment system for health care in which the provider is paid for each
service given is called - ANSWERS--fee-for-service
A person covered with an individual health plan - ANSWERS--is issued a
policy
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A person who is a nonsmoker, of average weight, and in excellent
health would most likely be in which risk classification? - ANSWERS--
Preferred
A producer must notify the Commissioner within _____ days of a felony
conviction. - ANSWERS--30 days
A producer's secretary who solicits prospects on the telephone -
ANSWERS--must be licensed as a producer
A(n) _______ insurance company is one that was formed under the
laws of a state other than NJ - ANSWERS--Foreign
According to the principle of Utmost Good Faith, the insured will
answer questions on the application to the best of their knowledge and
pay the required premium, while the insurer will deal fairly with the
insured and it's - ANSWERS--promise made
After an insured gives notice of loss, what must he/she do if the insurer
does not furnish forms? - ANSWERS--File written proof of loss
All _____ policies must be guaranteed renewable. - ANSWERS--long
term care
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All advertisements for health insurance shall make clear the identity of
the - ANSWERS--insurer
All Medicare Supplement policies MUST contain which provision? -
ANSWERS--Pre-existing conditions may only be excluded from coverage
for a maximum of 6 months
All of the following are factors would affect a health insurance policies
premium rate Except - ANSWERS--Residential address of the insured
All of the following are included as part of a contract in the entire
contract provision EXCEPT the - ANSWERS--changes made by the
producer
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 -
ANSWERS--bringing legal action against the insurer
An agent has committed an insurance crime that violates US CODE
1033 (interstate commerce). Who would be responsible for the
prosecution of this crime? - ANSWERS--US Attorney General
An agent is an individual that represents whom? - ANSWERS--Licensed
producer who has written contract to represent an insurer
NJ Health and Accident TEST FINAL EXAM AND PRACTICE
EXAM 20262027 BANK 2 VERSIONS QUESTIONS WITH
DETAILED VERIFIED ANSWERS EXAM QUESTIONS WILL
COME FROM HERE (100% CORRECT ANSWERS A+ GRADED
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 - ANSWERS--100% of the billed amount
A health insurance policy that allows an insurer to change the policy
owner's premiums, but NOT cancel the policy is called a(n) - ANSWERS--
guaranteed renewable policy
A health insurance policy where the insurer has the right to terminate
the policy for reasons other than the insured's health is called -
ANSWERS--conditionally renewable
A health insurance policy will typically cover - ANSWERS--Preventative
health services
A health insurer must be provided with written proof of loss ______
days after the date of loss - ANSWERS--90 days
,2|Page
A licensed producer is required to file notice to any changes of address
within how many days - ANSWERS--30 days
A master contract and certified coverage can be found in which type of
policy? - ANSWERS--Group
A medical provider that accepts Medicare Assignment must -
ANSWERS--accept payment based upon a defined Medicare schedule as
payment in full
A Medicare Supplement policy can be cancelled by the insurer for -
ANSWERS--Nonpayment
A medicare supplement policy must NOT contain benefits which -
ANSWERS--duplicate Medicare benefits
A newborn is required to be covered for _____ days from the moment
of birth - ANSWERS--30 days
A payment system for health care in which the provider is paid for each
service given is called - ANSWERS--fee-for-service
A person covered with an individual health plan - ANSWERS--is issued a
policy
,3|Page
A person who is a nonsmoker, of average weight, and in excellent
health would most likely be in which risk classification? - ANSWERS--
Preferred
A producer must notify the Commissioner within _____ days of a felony
conviction. - ANSWERS--30 days
A producer's secretary who solicits prospects on the telephone -
ANSWERS--must be licensed as a producer
A(n) _______ insurance company is one that was formed under the
laws of a state other than NJ - ANSWERS--Foreign
According to the principle of Utmost Good Faith, the insured will
answer questions on the application to the best of their knowledge and
pay the required premium, while the insurer will deal fairly with the
insured and it's - ANSWERS--promise made
After an insured gives notice of loss, what must he/she do if the insurer
does not furnish forms? - ANSWERS--File written proof of loss
All _____ policies must be guaranteed renewable. - ANSWERS--long
term care
, 4|Page
All advertisements for health insurance shall make clear the identity of
the - ANSWERS--insurer
All Medicare Supplement policies MUST contain which provision? -
ANSWERS--Pre-existing conditions may only be excluded from coverage
for a maximum of 6 months
All of the following are factors would affect a health insurance policies
premium rate Except - ANSWERS--Residential address of the insured
All of the following are included as part of a contract in the entire
contract provision EXCEPT the - ANSWERS--changes made by the
producer
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 -
ANSWERS--bringing legal action against the insurer
An agent has committed an insurance crime that violates US CODE
1033 (interstate commerce). Who would be responsible for the
prosecution of this crime? - ANSWERS--US Attorney General
An agent is an individual that represents whom? - ANSWERS--Licensed
producer who has written contract to represent an insurer
