Health Final Exam – NJ Accident & Health – 200+ Actual
Exam Questions & 100% Correct Answers | Latest Update
2026 | Exam Prep
1. Which type of medical expenses does Medicare Part D specifically address?
Doctor visits
Intensive care coverage
Prescription drugs
Hospital coverage
2. What is one action that an insurance company is prohibited from taking under
a guaranteed renewable premium benefit?
Increase the premiums on the basis of an entire classification
Increase the premiums on an individual basis
Stop renewing policy when the insured reaches a specified age
Cancel policy if premiums are not paid
3. What must a replacing insurer provide when replacing an existing group
health coverage?
Proof of underwriting
A claims history report
A notice of replacement
A summary of benefits
4. If a health insurance company uses a celebrity endorsement in its
advertisement, what must it ensure to comply with New Jersey regulations?
, The celebrity must have a personal experience with the insurance
policy.
The advertisement must include the company's trademark
prominently.
The advertisement must not mislead consumers about the coverage
or terms of the policy.
The celebrity must be a licensed insurance producer.
5. Disability income plans which require that the insured can Never change or
alter premium rates are usually considered?
optionally renewable
non-cancelable
conditionally renewable
guaranteed renewable
6. In a group medical expense health insurance plan, coverage for alcoholism is
treated as?
Requires a 3 day hospital stay
Treated as any other illness, sickness, or disease
Only for in-patient services
Not covered
7. Describe how coinsurance works in the context of a major medical plan.
Coinsurance is the fixed amount the policyholder pays for each visit.
Coinsurance is the annual limit on out-of-pocket expenses.
, Coinsurance is the percentage of costs that the policyholder is
responsible for after meeting their deductible.
Coinsurance is the total amount the insurer pays for a claim.
8. What is the coinsurance percentage for the major medical plan mentioned?
20%
100%
75%
80%
9. Given an insured with a stop-loss limit of $5,000, a deductible of $500, and an
80/20 coinsurance, calculate the total amount the insured will pay after
incurring $25,000 in covered losses.
$6,000
$4,500
$5,000
$5,500
10. A producer who voluntarily terminates their license can apply to be
relicensed without testing if:
Application is received by the Department within 24 months after the
termination and the continuing education requirements were
completed during the licensing period prior to voluntary termination
Application is received by the Department within 6 months after the
termination and the continuing education requirements were
completed during the licensing period prior to voluntary termination
, Application is received by the Department within 12 months after
the termination and the continuing education requirements were
completed during the licensing period prior to voluntary
termination
Application is received by the Department within 12 months after the
termination and the continuing education requirements will be
completed during the next licensing period
11. Which of the following is NOT a common exclusion for a medical expense
policy?
On-the-job injury
Physical therapy
Self inflicted injury
Act of war
12. The main impact of COBRA in health coverage is to...
Protect the rights of people with disabilities
Protect the privacy and security of health information
Expand the health plan choices of Medicare beneficiaries beyond
HMOs
Allow employees to continue their group health coverage for a
time after they leave a job
13. If a policyholder has a medical expense policy that excludes self-inflicted
injuries, how might this affect their coverage if they require treatment for a
mental health condition?
The policyholder will receive full coverage for all mental health
treatments.
Exam Questions & 100% Correct Answers | Latest Update
2026 | Exam Prep
1. Which type of medical expenses does Medicare Part D specifically address?
Doctor visits
Intensive care coverage
Prescription drugs
Hospital coverage
2. What is one action that an insurance company is prohibited from taking under
a guaranteed renewable premium benefit?
Increase the premiums on the basis of an entire classification
Increase the premiums on an individual basis
Stop renewing policy when the insured reaches a specified age
Cancel policy if premiums are not paid
3. What must a replacing insurer provide when replacing an existing group
health coverage?
Proof of underwriting
A claims history report
A notice of replacement
A summary of benefits
4. If a health insurance company uses a celebrity endorsement in its
advertisement, what must it ensure to comply with New Jersey regulations?
, The celebrity must have a personal experience with the insurance
policy.
The advertisement must include the company's trademark
prominently.
The advertisement must not mislead consumers about the coverage
or terms of the policy.
The celebrity must be a licensed insurance producer.
5. Disability income plans which require that the insured can Never change or
alter premium rates are usually considered?
optionally renewable
non-cancelable
conditionally renewable
guaranteed renewable
6. In a group medical expense health insurance plan, coverage for alcoholism is
treated as?
Requires a 3 day hospital stay
Treated as any other illness, sickness, or disease
Only for in-patient services
Not covered
7. Describe how coinsurance works in the context of a major medical plan.
Coinsurance is the fixed amount the policyholder pays for each visit.
Coinsurance is the annual limit on out-of-pocket expenses.
, Coinsurance is the percentage of costs that the policyholder is
responsible for after meeting their deductible.
Coinsurance is the total amount the insurer pays for a claim.
8. What is the coinsurance percentage for the major medical plan mentioned?
20%
100%
75%
80%
9. Given an insured with a stop-loss limit of $5,000, a deductible of $500, and an
80/20 coinsurance, calculate the total amount the insured will pay after
incurring $25,000 in covered losses.
$6,000
$4,500
$5,000
$5,500
10. A producer who voluntarily terminates their license can apply to be
relicensed without testing if:
Application is received by the Department within 24 months after the
termination and the continuing education requirements were
completed during the licensing period prior to voluntary termination
Application is received by the Department within 6 months after the
termination and the continuing education requirements were
completed during the licensing period prior to voluntary termination
, Application is received by the Department within 12 months after
the termination and the continuing education requirements were
completed during the licensing period prior to voluntary
termination
Application is received by the Department within 12 months after the
termination and the continuing education requirements will be
completed during the next licensing period
11. Which of the following is NOT a common exclusion for a medical expense
policy?
On-the-job injury
Physical therapy
Self inflicted injury
Act of war
12. The main impact of COBRA in health coverage is to...
Protect the rights of people with disabilities
Protect the privacy and security of health information
Expand the health plan choices of Medicare beneficiaries beyond
HMOs
Allow employees to continue their group health coverage for a
time after they leave a job
13. If a policyholder has a medical expense policy that excludes self-inflicted
injuries, how might this affect their coverage if they require treatment for a
mental health condition?
The policyholder will receive full coverage for all mental health
treatments.
