NJ Health & Accident Practice Final Exam – Actual Exam
Questions & 100% Correct Answers | Latest Update 2026
| Comprehensive Exam Prep
1. If a 65-year-old individual with chronic kidney disease applies for Medicare,
which factor would be irrelevant to their eligibility?
Income
Social security disability
Chronic kidney disease
Age
2. Group medical expense policies must cover which of the following?
lost income when an insured is out of work for ten days because of
the flu
Drug and alcohol rehabilitation
intentional self-inflicted wounds
. employee who is hurt while participating in the Army Reserves
training during her weekends off
3. Which of the following statements best describes the coordination of
benefits provision of group medical expense policies?
it permits all insurers covering a given insured to coordinate
benefits so that, among all of them, no more than 100% of a claim is
paid
it permits all insurers covering a given insured to coordinate benefits
so that, among all of them, no more than 80% of a claim is paid
, it permits insured to collect full benefits from every policy under
which they are covered
it prohibits consumers from being covered under more than 1 group
medical policy
4. What is the primary goal of the Coordination of Benefits provision in health
insurance plans?
avoid overpayment of claims
lower the cost of premiums
reduce adverse selection
reduce out-of-pocket costs
5. Which is not included as a part of a contract in the entire contract provision
Changes made by the agent
Insurance policy
Application
Endorsements
6. An insured was injured as an innocent bystander when someone committed a
felony. The insurer is
Liable for the loss
Likely to void the policy
Not liable for the loss
Personally liable for the loss
7. If a new insurance agent in New Jersey wants to earn commissions, what
steps must they take to be compliant with state regulations?
, Register with the NAIC before selling any policies.
Work for an insurance company for at least 5 years.
Complete a training program without needing a license.
Obtain a state license to sell insurance.
8. Discuss why college seminar participants might not qualify for group health
insurance in New Jersey.
College seminar participants do not meet the criteria for group
health insurance eligibility.
College seminar participants have access to individual health
insurance plans.
College seminar participants are covered under their parents' health
insurance.
College seminar participants are considered employees under New
Jersey law.
9. Describe the significance of the McCarran-Ferguson Act in the context of
health insurance regulation.
The McCarran-Ferguson Act eliminates state regulations for insurance
policies.
The McCarran-Ferguson Act mandates federal oversight of all
insurance transactions.
The McCarran-Ferguson Act applies only to life insurance policies.
The McCarran-Ferguson Act allows states to regulate insurance
transactions, ensuring that insurance practices are tailored to local
needs.
10. Who receives the certificate of coverage in a group health insurance plan?
, producer
sponsor
employer
employee
11. 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 reissue another subpoena
Commissioner must terminate the producer's appointment
Commissioner may incarcerate the producer
Commissioner may impose an administrative penalty
12. What is the maximum penalty amount for a first-time violation of New Jersey
Insurance law by a producer?
$4,000
$5,000
$3,000
$2,000
13. What is the required timeframe for a producer to inform the Department of
Banking and Insurance about a change in their business address?
20
30
60
10
14. Describe the implications of the requirement for a replacing insurer to
Questions & 100% Correct Answers | Latest Update 2026
| Comprehensive Exam Prep
1. If a 65-year-old individual with chronic kidney disease applies for Medicare,
which factor would be irrelevant to their eligibility?
Income
Social security disability
Chronic kidney disease
Age
2. Group medical expense policies must cover which of the following?
lost income when an insured is out of work for ten days because of
the flu
Drug and alcohol rehabilitation
intentional self-inflicted wounds
. employee who is hurt while participating in the Army Reserves
training during her weekends off
3. Which of the following statements best describes the coordination of
benefits provision of group medical expense policies?
it permits all insurers covering a given insured to coordinate
benefits so that, among all of them, no more than 100% of a claim is
paid
it permits all insurers covering a given insured to coordinate benefits
so that, among all of them, no more than 80% of a claim is paid
, it permits insured to collect full benefits from every policy under
which they are covered
it prohibits consumers from being covered under more than 1 group
medical policy
4. What is the primary goal of the Coordination of Benefits provision in health
insurance plans?
avoid overpayment of claims
lower the cost of premiums
reduce adverse selection
reduce out-of-pocket costs
5. Which is not included as a part of a contract in the entire contract provision
Changes made by the agent
Insurance policy
Application
Endorsements
6. An insured was injured as an innocent bystander when someone committed a
felony. The insurer is
Liable for the loss
Likely to void the policy
Not liable for the loss
Personally liable for the loss
7. If a new insurance agent in New Jersey wants to earn commissions, what
steps must they take to be compliant with state regulations?
, Register with the NAIC before selling any policies.
Work for an insurance company for at least 5 years.
Complete a training program without needing a license.
Obtain a state license to sell insurance.
8. Discuss why college seminar participants might not qualify for group health
insurance in New Jersey.
College seminar participants do not meet the criteria for group
health insurance eligibility.
College seminar participants have access to individual health
insurance plans.
College seminar participants are covered under their parents' health
insurance.
College seminar participants are considered employees under New
Jersey law.
9. Describe the significance of the McCarran-Ferguson Act in the context of
health insurance regulation.
The McCarran-Ferguson Act eliminates state regulations for insurance
policies.
The McCarran-Ferguson Act mandates federal oversight of all
insurance transactions.
The McCarran-Ferguson Act applies only to life insurance policies.
The McCarran-Ferguson Act allows states to regulate insurance
transactions, ensuring that insurance practices are tailored to local
needs.
10. Who receives the certificate of coverage in a group health insurance plan?
, producer
sponsor
employer
employee
11. 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 reissue another subpoena
Commissioner must terminate the producer's appointment
Commissioner may incarcerate the producer
Commissioner may impose an administrative penalty
12. What is the maximum penalty amount for a first-time violation of New Jersey
Insurance law by a producer?
$4,000
$5,000
$3,000
$2,000
13. What is the required timeframe for a producer to inform the Department of
Banking and Insurance about a change in their business address?
20
30
60
10
14. Describe the implications of the requirement for a replacing insurer to
