NY state insurance license practice exam 2025 questions
& answers
Which of these policies is considered to be a comprehensive health policy?
1. Major medical policy
2. Surgical policy
3. Limited benefit policy
4. Health Savings Account - answers-1. Major medical policy
Which activity requires an individual to be licensed as a consultant, rather than as an agent?
1. Giving advice on policy coverages to an insured
2. Receiving commissions from an insurance company
3. Binding insurance coverage with licensed insurers
4. Charging a fee for contracted insurance advisory services - answers-4. Charging a fee for
contracted insurance advisory services
,(Charging a fee for contracted insurance advisory services requires an individual to be licensed
as a consultant, rather than an agent.)
A MET third-party administrator may NOT perform which of the following functions?
1. Claims processing
2. Marketing of the plan
3. Underwriting the plan
4 .Insuring the plan - answers-2. Marketing of the plan
Under what circumstance does an accident and health insurer have the right to request an
autopsy?
1. When the claim exceeds an amount specified in the policy
2. When 2 days have passed after death
3. When not prohibited by state law
4. When consent is given by the beneficiary - answers-3. When not prohibited by state law
Which of the following accurately describes the "time limit on certain defenses"?
,1. After a stated period of time, claims cannot be denied due to material misrepresentation on
the application
2. All claims can be disputed after two years
3. An insured cannot file a lawsuit within 90 days of the claim being filed
4. The right to return an accident and health policy must be within 10 days of policy delivery -
answers-1. After a stated period of time, claims cannot be denied due to material
misrepresentation on the application
Patrick purchased a long-term care policy. He has a health condition for which medical
treatment was recommended by a physician within 6 months prior to the policy's effective date.
This condition is called a(n)
1. antecedent condition
2. pre-existing condition
3. hazardous condition
4. grandfathered condition - answers-2. pre-existing condition
Which of the following describes coverage for the Medicare Part B coinsurance?
1. Only a Long-term care policy will cover Medicare Part B coinsurance
, 2. A Medicare Supplement optional benefit
3. A Medicare Supplement core benefit
4. Medicare Part B does not require a coinsurance so no additional coverage is needed -
answers-3. A Medicare Supplement core benefit
Larry has a Major Medical Expense policy for his family with a $1,000 per family/per year
deductible and an 80/20 coinsurance provision. If Larry's family files four claims of $400, $800,
$100, and $700 in one year, how much will the insurance company pay?
1. $500
2. $800
3. $1,000
4. $1,200 - answers-2. $800
(($400 + $800 + $100 + $700 = $2,000. The insurance company pays 80% of $1,000 (outstanding
balance after deductible is paid), or $800.))
Long-term care policies issued in New York must provide benefits for at least
1. 6 months
2. 12 months
& answers
Which of these policies is considered to be a comprehensive health policy?
1. Major medical policy
2. Surgical policy
3. Limited benefit policy
4. Health Savings Account - answers-1. Major medical policy
Which activity requires an individual to be licensed as a consultant, rather than as an agent?
1. Giving advice on policy coverages to an insured
2. Receiving commissions from an insurance company
3. Binding insurance coverage with licensed insurers
4. Charging a fee for contracted insurance advisory services - answers-4. Charging a fee for
contracted insurance advisory services
,(Charging a fee for contracted insurance advisory services requires an individual to be licensed
as a consultant, rather than an agent.)
A MET third-party administrator may NOT perform which of the following functions?
1. Claims processing
2. Marketing of the plan
3. Underwriting the plan
4 .Insuring the plan - answers-2. Marketing of the plan
Under what circumstance does an accident and health insurer have the right to request an
autopsy?
1. When the claim exceeds an amount specified in the policy
2. When 2 days have passed after death
3. When not prohibited by state law
4. When consent is given by the beneficiary - answers-3. When not prohibited by state law
Which of the following accurately describes the "time limit on certain defenses"?
,1. After a stated period of time, claims cannot be denied due to material misrepresentation on
the application
2. All claims can be disputed after two years
3. An insured cannot file a lawsuit within 90 days of the claim being filed
4. The right to return an accident and health policy must be within 10 days of policy delivery -
answers-1. After a stated period of time, claims cannot be denied due to material
misrepresentation on the application
Patrick purchased a long-term care policy. He has a health condition for which medical
treatment was recommended by a physician within 6 months prior to the policy's effective date.
This condition is called a(n)
1. antecedent condition
2. pre-existing condition
3. hazardous condition
4. grandfathered condition - answers-2. pre-existing condition
Which of the following describes coverage for the Medicare Part B coinsurance?
1. Only a Long-term care policy will cover Medicare Part B coinsurance
, 2. A Medicare Supplement optional benefit
3. A Medicare Supplement core benefit
4. Medicare Part B does not require a coinsurance so no additional coverage is needed -
answers-3. A Medicare Supplement core benefit
Larry has a Major Medical Expense policy for his family with a $1,000 per family/per year
deductible and an 80/20 coinsurance provision. If Larry's family files four claims of $400, $800,
$100, and $700 in one year, how much will the insurance company pay?
1. $500
2. $800
3. $1,000
4. $1,200 - answers-2. $800
(($400 + $800 + $100 + $700 = $2,000. The insurance company pays 80% of $1,000 (outstanding
balance after deductible is paid), or $800.))
Long-term care policies issued in New York must provide benefits for at least
1. 6 months
2. 12 months
