New Jersey Health Final. Practice Quiz.
The benefit period under New Jersey Temporary Disability Law is:
A) 14 weeks
B) 26 weeks
C) 86 weeks
D) 52 weeks - correct answer-B
In the case of replacement of a group health insurance policy, if a person is not
covered by the succeeding plan's eligibility rules because of absence from work and
confinement in a hospital on the effective date, but the person is a member of an
eligible class and was covered by the prior plan on its termination date:
A)The prior carrier will have to continue to cover that person
B)The prior carrier and succeeding carrier will have to jointly provide continuing
benefits on a pro rata basics
C) The succeeding carrier will nonetheless have to provide coverage for that person
D) That person's coverage will begin only upon a return to active work status -
correct answer-A
All of the following are true about the Temporary Disability Law in New Jersey,
EXCEPT:
A) Generally, the law covers non-occupational disabilities
B) Political subdivisions of the state and state universities are not permitted to
participate in the state plan
C) All covered individuals are entitled to temporary disability benefits under either the
state plan or a private plan
D) No benefits are payable from the state fund for any period for which benefits are
payable under any Workers Compensation or occupational disease law - correct
answer-B
A Medicare Supplement policy shall not provide for termination of coverage for which
of the following reason?
A) Continuous loss which commenced while the policy was in force
B) Solely on the grounds of a covered person's age or deterioration of health
C) Both of the choices
D) Neither of the choices - correct answer-B
Insurers and hospital or medical service corporations issuing Medicare Supplement
policies must deliver to all applicants a Buyers Guide titled:
,A) A Guide to Medicare
B) A Guide to Medicare Part B
C) Bridging the Medicare Gaps, A Guide to Medicare Supplements
D) A Guide to Medicare Part A - correct answer-C
95) Which of the following is true about a Medicare Supplement policy that provides
for payment of benefits based on the standards described as "usual and customary"
or "reasonable and customary"?
A) The policy must include a definition & explanation of the above terms in the
outline of coverage
B) The policy must include only a definition of the above terms & no explanation
required
Ck Only preexisting condition exclusions must be defined and explained
D) None of the choices - correct answer-A
Under a Medicare Supplement policy, the outline of coverage is designed to do
which of the
following?
A) Clearly identify the insurance company
B) Describe the coverage
C) Both of the choices
D) Neither of the choices - correct answer-B
Which of the following is true concerning a Medicare Supplement policy which is
intended to replace any other accident or sickness policy currently in force?
A) Application forms must include a question designed to elicit information as to
whether
this policy is intended to replace any other accident or sickness policy now in force
B) Upon determining that a sale will involve replacement, the insurer or agent must
furnish a "Notice Regarding Replacement"
C) Both of the choices
D) Neither of the choices - correct answer-C
If credit accident and health insurance is terminated before the scheduled maturity
date of the debt, any unearned premium held by the insurer will be:
A) Refunded to the debtor
B) Refunded only if the amount is greater than $10
C) Added to the insurer's surplus funds
D) Debited to an account for "bad debts" - correct answer-A
,Policies required to provide home health care benefits must cover at least:
A) 30 home health visits annually
B) 60 home health visits annually
C) 90 home health visits annually
D) 120 home health visits annually - correct answer-B
Medicare Supplement policies shall provide that benefits to cover cost sharing
amounts under Medicare will:
A) Automatically change to coincide with changes in Medicare deductibles and
coinsurance payments
B) Change upon renewal to coincide with changes in Medicare deductibles and
coinsurance payments
C) Automatically change to meet Medicare deductibles only
D) Automatically change to meet Medicare coinsurance payments only - correct
answer-A
Under a Medicare Supplement policy, denial of a claim for losses incurred as a result
of preexisting conditions may not be denied as a result of a preexisting condition
after:
A) 12 months from the effective date of coverage
B) 24 months from the effective date of coverage
C) 3 months from the effective date of coverage
D) 6 months from the effective date of coverage - correct answer-D
Medicare Supplement policy shall not provide for termination of coverage -except for
nonpayment of premium- for which of the following?
A) Dependents of an eligible spouse because the insured's coverage has terminated
B) An eligible spouse because the insured's coverage has terminated
C) An insured because an eligible dependent's coverage has terminated
D) A spouse because an eligible dependent's coverage has terminated - correct
answer-B
Concerning Medicare Supplement policies, which of the following is/are true?
A) Medicare Supplement policies may not indemnify for losses from sickness on a
different basis than losses from accidents
B) Some Medicare Supplement policies indemnify for losses resulting from
accidents only
C) Both of the choices
, D) Neither of the choices - correct answer-A
Health insurance policies, other than those issued by a direct-response insurer, must
provide for a full refund of premium if the contract is returned within:
A) 10 days
C) 20 days
B) 30 days
D) 60 days - correct answer-A
Health insurance policies issued by a direct-response insurer must provide for a full
refund of premium if the premium if the contract is returned within:
A)10 days
B) 20 days
C) 30 days
D) 60 days - correct answer-C
In New Jersey, benefits for treatment of alcoholism must be included in health
insurance policies providing:
A) Hospital income benefits
B) Student accident benefits
C) Surgical Expense benefits
D) Hospital and Medical expense benefits - correct answer-D
Medicare supplement policies issued on an individual basis must return in benefit
payments to policyholders an amount at least equal to:
A) 65% of the aggregate premiums collected
B) 75% of the aggregate premiums collected
C) 80% of the aggregate premiums collected
D) 90% of the aggregate premiums collected - correct answer-A
Medicare supplement policies issued on group basis must return in benefit payments
to
policyholders an amount at least equal to:
A) 65% of the aggregate premiums collected
B) 75% of the aggregate premiums collected
C) 80% of the aggregate premiums collected
D) 90% of the aggregate premiums collected. - correct answer-B
The benefit period under New Jersey Temporary Disability Law is:
A) 14 weeks
B) 26 weeks
C) 86 weeks
D) 52 weeks - correct answer-B
In the case of replacement of a group health insurance policy, if a person is not
covered by the succeeding plan's eligibility rules because of absence from work and
confinement in a hospital on the effective date, but the person is a member of an
eligible class and was covered by the prior plan on its termination date:
A)The prior carrier will have to continue to cover that person
B)The prior carrier and succeeding carrier will have to jointly provide continuing
benefits on a pro rata basics
C) The succeeding carrier will nonetheless have to provide coverage for that person
D) That person's coverage will begin only upon a return to active work status -
correct answer-A
All of the following are true about the Temporary Disability Law in New Jersey,
EXCEPT:
A) Generally, the law covers non-occupational disabilities
B) Political subdivisions of the state and state universities are not permitted to
participate in the state plan
C) All covered individuals are entitled to temporary disability benefits under either the
state plan or a private plan
D) No benefits are payable from the state fund for any period for which benefits are
payable under any Workers Compensation or occupational disease law - correct
answer-B
A Medicare Supplement policy shall not provide for termination of coverage for which
of the following reason?
A) Continuous loss which commenced while the policy was in force
B) Solely on the grounds of a covered person's age or deterioration of health
C) Both of the choices
D) Neither of the choices - correct answer-B
Insurers and hospital or medical service corporations issuing Medicare Supplement
policies must deliver to all applicants a Buyers Guide titled:
,A) A Guide to Medicare
B) A Guide to Medicare Part B
C) Bridging the Medicare Gaps, A Guide to Medicare Supplements
D) A Guide to Medicare Part A - correct answer-C
95) Which of the following is true about a Medicare Supplement policy that provides
for payment of benefits based on the standards described as "usual and customary"
or "reasonable and customary"?
A) The policy must include a definition & explanation of the above terms in the
outline of coverage
B) The policy must include only a definition of the above terms & no explanation
required
Ck Only preexisting condition exclusions must be defined and explained
D) None of the choices - correct answer-A
Under a Medicare Supplement policy, the outline of coverage is designed to do
which of the
following?
A) Clearly identify the insurance company
B) Describe the coverage
C) Both of the choices
D) Neither of the choices - correct answer-B
Which of the following is true concerning a Medicare Supplement policy which is
intended to replace any other accident or sickness policy currently in force?
A) Application forms must include a question designed to elicit information as to
whether
this policy is intended to replace any other accident or sickness policy now in force
B) Upon determining that a sale will involve replacement, the insurer or agent must
furnish a "Notice Regarding Replacement"
C) Both of the choices
D) Neither of the choices - correct answer-C
If credit accident and health insurance is terminated before the scheduled maturity
date of the debt, any unearned premium held by the insurer will be:
A) Refunded to the debtor
B) Refunded only if the amount is greater than $10
C) Added to the insurer's surplus funds
D) Debited to an account for "bad debts" - correct answer-A
,Policies required to provide home health care benefits must cover at least:
A) 30 home health visits annually
B) 60 home health visits annually
C) 90 home health visits annually
D) 120 home health visits annually - correct answer-B
Medicare Supplement policies shall provide that benefits to cover cost sharing
amounts under Medicare will:
A) Automatically change to coincide with changes in Medicare deductibles and
coinsurance payments
B) Change upon renewal to coincide with changes in Medicare deductibles and
coinsurance payments
C) Automatically change to meet Medicare deductibles only
D) Automatically change to meet Medicare coinsurance payments only - correct
answer-A
Under a Medicare Supplement policy, denial of a claim for losses incurred as a result
of preexisting conditions may not be denied as a result of a preexisting condition
after:
A) 12 months from the effective date of coverage
B) 24 months from the effective date of coverage
C) 3 months from the effective date of coverage
D) 6 months from the effective date of coverage - correct answer-D
Medicare Supplement policy shall not provide for termination of coverage -except for
nonpayment of premium- for which of the following?
A) Dependents of an eligible spouse because the insured's coverage has terminated
B) An eligible spouse because the insured's coverage has terminated
C) An insured because an eligible dependent's coverage has terminated
D) A spouse because an eligible dependent's coverage has terminated - correct
answer-B
Concerning Medicare Supplement policies, which of the following is/are true?
A) Medicare Supplement policies may not indemnify for losses from sickness on a
different basis than losses from accidents
B) Some Medicare Supplement policies indemnify for losses resulting from
accidents only
C) Both of the choices
, D) Neither of the choices - correct answer-A
Health insurance policies, other than those issued by a direct-response insurer, must
provide for a full refund of premium if the contract is returned within:
A) 10 days
C) 20 days
B) 30 days
D) 60 days - correct answer-A
Health insurance policies issued by a direct-response insurer must provide for a full
refund of premium if the premium if the contract is returned within:
A)10 days
B) 20 days
C) 30 days
D) 60 days - correct answer-C
In New Jersey, benefits for treatment of alcoholism must be included in health
insurance policies providing:
A) Hospital income benefits
B) Student accident benefits
C) Surgical Expense benefits
D) Hospital and Medical expense benefits - correct answer-D
Medicare supplement policies issued on an individual basis must return in benefit
payments to policyholders an amount at least equal to:
A) 65% of the aggregate premiums collected
B) 75% of the aggregate premiums collected
C) 80% of the aggregate premiums collected
D) 90% of the aggregate premiums collected - correct answer-A
Medicare supplement policies issued on group basis must return in benefit payments
to
policyholders an amount at least equal to:
A) 65% of the aggregate premiums collected
B) 75% of the aggregate premiums collected
C) 80% of the aggregate premiums collected
D) 90% of the aggregate premiums collected. - correct answer-B
