Update 2024-2025 Actual Exam with 120
Questions and 100% Verified Correct Answers
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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 -
CORRECT ANSWER: 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) - CORRECT ANSWER: 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 - CORRECT ANSWER: conditionally
renewable
A health insurance policy will typically cover - CORRECT ANSWER: Preventative health
services
A health insurer must be provided with written proof of loss ______ days after the date
of loss - CORRECT ANSWER: 90 days
A licensed producer is required to file notice to any changes of address within how
many days - CORRECT ANSWER: 30 days
A master contract and certified coverage can be found in which type of policy? -
CORRECT ANSWER: Group
, A medical provider that accepts Medicare Assignment must - CORRECT ANSWER:
accept payment based upon a defined Medicare schedule as payment in full
A Medicare Supplement policy can be cancelled by the insurer for - CORRECT
ANSWER: Nonpayment
A medicare supplement policy must NOT contain benefits which - CORRECT ANSWER:
duplicate Medicare benefits
A newborn is required to be covered for _____ days from the moment of birth -
CORRECT ANSWER: 30 days
A payment system for health care in which the provider is paid for each service given is
called - CORRECT ANSWER: fee-for-service
A person covered with an individual health plan - CORRECT ANSWER: 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? - CORRECT ANSWER: Preferred
A producer must notify the Commissioner within _____ days of a felony conviction. -
CORRECT ANSWER: 30 days
A producer's secretary who solicits prospects on the telephone - CORRECT ANSWER:
must be licensed as a producer
A(n) _______ insurance company is one that was formed under the laws of a state
other than NJ - CORRECT ANSWER: Foreign