NJ Health and Accident
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 - -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) - -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 - -conditionally
renewable
A health insurance policy will typically cover - ✅✅-Preventative health
services
✅✅
A health insurer must be provided with written proof of loss ______ days after
the date of loss - -90 days
✅✅
A licensed producer is required to file notice to any changes of address within
how many days - -30 days
✅✅
A master contract and certified coverage can be found in which type of policy?
- -Group
A medical provider that accepts Medicare Assignment must - ✅✅
-accept
payment based upon a defined Medicare schedule as payment in full
✅✅
A Medicare Supplement policy can be cancelled by the insurer for -
-Nonpayment
✅✅
A medicare supplement policy must NOT contain benefits which -
-duplicate Medicare benefits
✅✅
A newborn is required to be covered for _____ days from the moment of birth
- -30 days
✅✅
A payment system for health care in which the provider is paid for each
service given is called - -fee-for-service
, A person covered with an individual health plan - ✅✅-is issued a policy
✅✅
A person who is a nonsmoker, of average weight, and in excellent health
would most likely be in which risk classification? - -Preferred
✅✅
A producer must notify the Commissioner within _____ days of a felony
conviction. - -30 days
A producer's secretary who solicits prospects on the telephone - ✅✅-must
be licensed as a producer
✅✅
A(n) _______ insurance company is one that was formed under the laws of a
state other than NJ - -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 -
-promise made
✅✅
After an insured gives notice of loss, what must he/she do if the insurer does
not furnish forms? - -File written proof of loss
All _____ policies must be guaranteed renewable. - ✅✅-long term care
✅✅
All advertisements for health insurance shall make clear the identity of the -
-insurer
✅✅
All Medicare Supplement policies MUST contain which provision? -
-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 - -Residential address of the insured
✅✅
All of the following are included as part of a contract in the entire contract
provision EXCEPT the - -changes made by the producer
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 - -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) - -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 - -conditionally
renewable
A health insurance policy will typically cover - ✅✅-Preventative health
services
✅✅
A health insurer must be provided with written proof of loss ______ days after
the date of loss - -90 days
✅✅
A licensed producer is required to file notice to any changes of address within
how many days - -30 days
✅✅
A master contract and certified coverage can be found in which type of policy?
- -Group
A medical provider that accepts Medicare Assignment must - ✅✅
-accept
payment based upon a defined Medicare schedule as payment in full
✅✅
A Medicare Supplement policy can be cancelled by the insurer for -
-Nonpayment
✅✅
A medicare supplement policy must NOT contain benefits which -
-duplicate Medicare benefits
✅✅
A newborn is required to be covered for _____ days from the moment of birth
- -30 days
✅✅
A payment system for health care in which the provider is paid for each
service given is called - -fee-for-service
, A person covered with an individual health plan - ✅✅-is issued a policy
✅✅
A person who is a nonsmoker, of average weight, and in excellent health
would most likely be in which risk classification? - -Preferred
✅✅
A producer must notify the Commissioner within _____ days of a felony
conviction. - -30 days
A producer's secretary who solicits prospects on the telephone - ✅✅-must
be licensed as a producer
✅✅
A(n) _______ insurance company is one that was formed under the laws of a
state other than NJ - -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 -
-promise made
✅✅
After an insured gives notice of loss, what must he/she do if the insurer does
not furnish forms? - -File written proof of loss
All _____ policies must be guaranteed renewable. - ✅✅-long term care
✅✅
All advertisements for health insurance shall make clear the identity of the -
-insurer
✅✅
All Medicare Supplement policies MUST contain which provision? -
-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 - -Residential address of the insured
✅✅
All of the following are included as part of a contract in the entire contract
provision EXCEPT the - -changes made by the producer
