Page 1 of 48
NJ HEALTH AND ACCIDENT
INSURANCE ACTUAL 2025 FINAL
EXAM QUESTIONS WITH CORRECT
DETAILED ANSWERS WITH 450
QUESTIONS AND ANSWERS ALREADY
GRADED A+
"Which type of plan would be most appropriate for an individual on Medicare and is concerned
that Medicare will NOT pay for charges exceeding the approved amount? - CORRECT ANSWER=>
Medicare supplement plan F"
"Which of the following is NOT a common exclusion for a medical expense policy?
Physical therapy
Act of war
on the job injury
self inflicted injury - CORRECT ANSWER=> Physical therapy"
"Twisting is best defined as - CORRECT ANSWER=> using misrepresentation to induce an insured
person to terminate an existing policy and purchase a new policy"
"The reinstatement provision in a health insurance policy is - CORRECT ANSWER=> Mandatory"
"A producer has recently died and leaves behind a spouse. In order for the producer's insurance
business to continue, the Department of Banking and Insurance may issue to the producer's
spouse a(n) - CORRECT ANSWER=> temporary insurance license"
, Page 2 of 48
"Pierre the producer receives a premium for an individual health insurance policy. Pierre MUST
remit the premium to his insurer within ____ business days of receipt - CORRECT ANSWER=> 7"
"Nina just passed her NJ insurance licensing examination. She is REQUIRED to apply for a
producer's license within ____ months - CORRECT ANSWER=> 12"
"Which of the following MUST contain a "statement of policy cost and benefit information"? -
CORRECT ANSWER=> Policy Summary"
"The department of banking and insurance can make information pertaining to a producers
license available through - CORRECT ANSWER=> Certificate of License Status Report"
"Intentional withholding of material facts that would affect an insurance policy's validity is
called a(n) - CORRECT ANSWER=> Concealment"
"Under the NJ Continuance of Benefits law, notice to extend coverage is required within how
many days of a qualifying event? - CORRECT ANSWER=> 30"
"Which of the following does Medicare Part D cover?
Intensive care coverage
Doctor visits
Prescription drugs
Hospital coverage - CORRECT ANSWER=> Prescription drugs"
"Which of these gaps in Medicare coverage is addressed with Medicare Supplemental
Insurance? - CORRECT ANSWER=> Medicare in-hospital deductible"
"Under group health insurance, a certificate of coverage is issued to the - CORRECT ANSWER=>
employee"
"Claims payable to a Disability Income insured, even when the insured can continue to work, are
the result of a - CORRECT ANSWER=> Presumptive disability"
"A dread disease policy is considered to be a type of - CORRECT ANSWER=> Limited health
insurance policy"
, Page 3 of 48
"How often must an insurance producer's license in NJ be renewed? - CORRECT ANSWER=> every
2 years"
"Which type of disability would be less than total impairment and equal to permanent
impairment? - CORRECT ANSWER=> Permanent partial disability"
"An insurance consultant is BEST defined as a(n) - CORRECT ANSWER=> Producer who charges
fees for advice"
"Kathy pays a monthly premium on her health insurance policy. How long is her grace period? -
CORRECT ANSWER=> 10 days"
"Susan is insured through her Group Health Insurance plan and changed her coverage to an
individual plan with the same insurer after her employment was terminated. This change is
called a(n)
crossover
conversion
exchange
extension of benefits - CORRECT ANSWER=> Conversion"
"What amount will be paid under a policy where the insured misstated his/her age? - CORRECT
ANSWER=> An amount the premium would have purchased at the correct age"
"The IRS allows a taxpayer to deduct medical expenses that exceed 7.5% of their adjusted gross
income. Which of the following is considered a tax deductible medical expense under this rule?
- CORRECT ANSWER=> Long term care insurance premiums"
"Which of these may Not be used in a health insurance advertisement?
celebrity endorsement
statement that highlights coverage amounts
paid testimonial
insurance company's trademark instead of the company's actual name - CORRECT ANSWER=>
insurance company's trademark instead of the company's actual name"
, Page 4 of 48
"In group health care, what is the purpose of the coordination of benefits provision? - CORRECT
ANSWER=> Determines what is paid by the primary and secondary insurers in the event of a
claim"
"A clause that allows that allows an insurer the right to terminate coverage at any anniversary
date is called a(n) - CORRECT ANSWER=> Optional renewability clause"
"Which of the following is considered to be a point of service (POS) plan?
A) Preferred provider organization B) Managed care plan
C) Protected care provider
D) Restricted provider organization - CORRECT ANSWER=> B) Managed care plan"
"A person who is a nonsmoker, of average weight, and in excellent health would most likely be
in which risk classification? - CORRECT ANSWER=> Preferred"
"The NJ Life and Health Insurance Guaranty Association is - CORRECT ANSWER=> Funded by
assessments on member companies"
"When an insured changes to a more hazardous occupation, which disability policy provision
allows an insurer to adjust policy benefits and rates? - CORRECT ANSWER=> Change of
occupation provision"
"Which of the following would be considered a possible applicant and contract policyholder for
group health benefits?
A. Human resource department
B. Employer
C. Insured employee
D. Insurance company - CORRECT ANSWER=> Employer"
"Continuing education credits may be approved for which of the following?
Pre-licensing education
motivational education
sales and marketing education
ethics - CORRECT ANSWER=> Ethics"
NJ HEALTH AND ACCIDENT
INSURANCE ACTUAL 2025 FINAL
EXAM QUESTIONS WITH CORRECT
DETAILED ANSWERS WITH 450
QUESTIONS AND ANSWERS ALREADY
GRADED A+
"Which type of plan would be most appropriate for an individual on Medicare and is concerned
that Medicare will NOT pay for charges exceeding the approved amount? - CORRECT ANSWER=>
Medicare supplement plan F"
"Which of the following is NOT a common exclusion for a medical expense policy?
Physical therapy
Act of war
on the job injury
self inflicted injury - CORRECT ANSWER=> Physical therapy"
"Twisting is best defined as - CORRECT ANSWER=> using misrepresentation to induce an insured
person to terminate an existing policy and purchase a new policy"
"The reinstatement provision in a health insurance policy is - CORRECT ANSWER=> Mandatory"
"A producer has recently died and leaves behind a spouse. In order for the producer's insurance
business to continue, the Department of Banking and Insurance may issue to the producer's
spouse a(n) - CORRECT ANSWER=> temporary insurance license"
, Page 2 of 48
"Pierre the producer receives a premium for an individual health insurance policy. Pierre MUST
remit the premium to his insurer within ____ business days of receipt - CORRECT ANSWER=> 7"
"Nina just passed her NJ insurance licensing examination. She is REQUIRED to apply for a
producer's license within ____ months - CORRECT ANSWER=> 12"
"Which of the following MUST contain a "statement of policy cost and benefit information"? -
CORRECT ANSWER=> Policy Summary"
"The department of banking and insurance can make information pertaining to a producers
license available through - CORRECT ANSWER=> Certificate of License Status Report"
"Intentional withholding of material facts that would affect an insurance policy's validity is
called a(n) - CORRECT ANSWER=> Concealment"
"Under the NJ Continuance of Benefits law, notice to extend coverage is required within how
many days of a qualifying event? - CORRECT ANSWER=> 30"
"Which of the following does Medicare Part D cover?
Intensive care coverage
Doctor visits
Prescription drugs
Hospital coverage - CORRECT ANSWER=> Prescription drugs"
"Which of these gaps in Medicare coverage is addressed with Medicare Supplemental
Insurance? - CORRECT ANSWER=> Medicare in-hospital deductible"
"Under group health insurance, a certificate of coverage is issued to the - CORRECT ANSWER=>
employee"
"Claims payable to a Disability Income insured, even when the insured can continue to work, are
the result of a - CORRECT ANSWER=> Presumptive disability"
"A dread disease policy is considered to be a type of - CORRECT ANSWER=> Limited health
insurance policy"
, Page 3 of 48
"How often must an insurance producer's license in NJ be renewed? - CORRECT ANSWER=> every
2 years"
"Which type of disability would be less than total impairment and equal to permanent
impairment? - CORRECT ANSWER=> Permanent partial disability"
"An insurance consultant is BEST defined as a(n) - CORRECT ANSWER=> Producer who charges
fees for advice"
"Kathy pays a monthly premium on her health insurance policy. How long is her grace period? -
CORRECT ANSWER=> 10 days"
"Susan is insured through her Group Health Insurance plan and changed her coverage to an
individual plan with the same insurer after her employment was terminated. This change is
called a(n)
crossover
conversion
exchange
extension of benefits - CORRECT ANSWER=> Conversion"
"What amount will be paid under a policy where the insured misstated his/her age? - CORRECT
ANSWER=> An amount the premium would have purchased at the correct age"
"The IRS allows a taxpayer to deduct medical expenses that exceed 7.5% of their adjusted gross
income. Which of the following is considered a tax deductible medical expense under this rule?
- CORRECT ANSWER=> Long term care insurance premiums"
"Which of these may Not be used in a health insurance advertisement?
celebrity endorsement
statement that highlights coverage amounts
paid testimonial
insurance company's trademark instead of the company's actual name - CORRECT ANSWER=>
insurance company's trademark instead of the company's actual name"
, Page 4 of 48
"In group health care, what is the purpose of the coordination of benefits provision? - CORRECT
ANSWER=> Determines what is paid by the primary and secondary insurers in the event of a
claim"
"A clause that allows that allows an insurer the right to terminate coverage at any anniversary
date is called a(n) - CORRECT ANSWER=> Optional renewability clause"
"Which of the following is considered to be a point of service (POS) plan?
A) Preferred provider organization B) Managed care plan
C) Protected care provider
D) Restricted provider organization - CORRECT ANSWER=> B) Managed care plan"
"A person who is a nonsmoker, of average weight, and in excellent health would most likely be
in which risk classification? - CORRECT ANSWER=> Preferred"
"The NJ Life and Health Insurance Guaranty Association is - CORRECT ANSWER=> Funded by
assessments on member companies"
"When an insured changes to a more hazardous occupation, which disability policy provision
allows an insurer to adjust policy benefits and rates? - CORRECT ANSWER=> Change of
occupation provision"
"Which of the following would be considered a possible applicant and contract policyholder for
group health benefits?
A. Human resource department
B. Employer
C. Insured employee
D. Insurance company - CORRECT ANSWER=> Employer"
"Continuing education credits may be approved for which of the following?
Pre-licensing education
motivational education
sales and marketing education
ethics - CORRECT ANSWER=> Ethics"
