Health Final Exam - NJ Accident and Health
Study online at https://quizlet.com/_9v40l3
1. The Commissioner must approve: Continuing education courses
2. Employer sponsored group health insurance provides coverage for which
of the following?
Self-inflicted injuries
cosmetic surgery
custodial care
alcoholism: alcoholism
3. A Medicare supplement policy can be cancelled by the insurer for: Nonpay-
ment
4. Which entity is responsible for regulating insurance advertising in NJ?: New
Jersey Department of Banking and Insurance
5. Which of the following are retained at the expense of an insurance buyer to
give advice on insurance needed by the buyer?
Brokers and consultants
Insurance prospectors
Third-party adminstrators
Agents: Brokers and consultants
6. Written notice for a health claim must be given to the insurer ___ days after
the occurrence of the loss.: 20
7. In which of the following situations would the insurer be liable for a loss?
a) The insured skipped a payment beyond the 31 day grace period
b) The insured was injured while participating in an illegal occupation
c) The insured was given a notice of cancellation from the insurer
d) The insured suffered an injury as an innocent bystander during a bank
robbery: d) The insured suffered an injury as an innocent bystander during a bank
robbery
8. When a Medicare supplement policy is purchased during the open enroll-
ment period: The policy must be issued regardless of health status
9. In what form do disability income policies typically pay benefits?: Periodic
income
10. What is considered to be the primary reason for buying life insurance?: -
Provide death benefits
11. A newborn is required to be covered for ____ days from the moment of
birth: 30
12. Once an accident and health insurance policy has been in force for ___
year(s), the policy may NOT be contested by the insurer: 2
, Health Final Exam - NJ Accident and Health
Study online at https://quizlet.com/_9v40l3
13. A doctor who accepts Medicare assignment agrees to which of the follow-
ing
- Doctor may charge up to a maximum of 15% more than Medicare pays for
the service
- Doctor is not bound by Medicare's limitations on charges
- Doctor cannot charge more than Medicare's scheduled coverage
- Doctor bills the Medicare beneficiary directly for services performed: Doctor
cannot charge more than Medicare's scheduled coverage
14. What is issued to each employee with an employer health plan?: Certificate
15. What is the tax liability for employer contributions in Health Savings Ac-
counts (HSA's)?: No tax payment needed
16. All of these are considered sources of information that can assist an
underwriter in determining whether or not to accept a risk EXCEPT
Agent's report
Medical Information Bureau (MIB)
Inspection reports
National Association of Insurance Underwriters: National Association of Insur-
ance Underwriters
17. In NJ, health insurance advertisements are required to contain the: insur-
ance company's name
18. Replacement regulation is designed to protect the interests of: Policyown-
ers
19. The Commissioner of Insurance is appointed by: The governor
20. 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?: Medicare supplement plan F
21. 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: Physical therapy
22. Twisting is best defined as: using misrepresentation to induce an insured
person to terminate an existing policy and purchase a new policy
23. The reinstatement provision in a health insurance policy is: Mandatory
Study online at https://quizlet.com/_9v40l3
1. The Commissioner must approve: Continuing education courses
2. Employer sponsored group health insurance provides coverage for which
of the following?
Self-inflicted injuries
cosmetic surgery
custodial care
alcoholism: alcoholism
3. A Medicare supplement policy can be cancelled by the insurer for: Nonpay-
ment
4. Which entity is responsible for regulating insurance advertising in NJ?: New
Jersey Department of Banking and Insurance
5. Which of the following are retained at the expense of an insurance buyer to
give advice on insurance needed by the buyer?
Brokers and consultants
Insurance prospectors
Third-party adminstrators
Agents: Brokers and consultants
6. Written notice for a health claim must be given to the insurer ___ days after
the occurrence of the loss.: 20
7. In which of the following situations would the insurer be liable for a loss?
a) The insured skipped a payment beyond the 31 day grace period
b) The insured was injured while participating in an illegal occupation
c) The insured was given a notice of cancellation from the insurer
d) The insured suffered an injury as an innocent bystander during a bank
robbery: d) The insured suffered an injury as an innocent bystander during a bank
robbery
8. When a Medicare supplement policy is purchased during the open enroll-
ment period: The policy must be issued regardless of health status
9. In what form do disability income policies typically pay benefits?: Periodic
income
10. What is considered to be the primary reason for buying life insurance?: -
Provide death benefits
11. A newborn is required to be covered for ____ days from the moment of
birth: 30
12. Once an accident and health insurance policy has been in force for ___
year(s), the policy may NOT be contested by the insurer: 2
, Health Final Exam - NJ Accident and Health
Study online at https://quizlet.com/_9v40l3
13. A doctor who accepts Medicare assignment agrees to which of the follow-
ing
- Doctor may charge up to a maximum of 15% more than Medicare pays for
the service
- Doctor is not bound by Medicare's limitations on charges
- Doctor cannot charge more than Medicare's scheduled coverage
- Doctor bills the Medicare beneficiary directly for services performed: Doctor
cannot charge more than Medicare's scheduled coverage
14. What is issued to each employee with an employer health plan?: Certificate
15. What is the tax liability for employer contributions in Health Savings Ac-
counts (HSA's)?: No tax payment needed
16. All of these are considered sources of information that can assist an
underwriter in determining whether or not to accept a risk EXCEPT
Agent's report
Medical Information Bureau (MIB)
Inspection reports
National Association of Insurance Underwriters: National Association of Insur-
ance Underwriters
17. In NJ, health insurance advertisements are required to contain the: insur-
ance company's name
18. Replacement regulation is designed to protect the interests of: Policyown-
ers
19. The Commissioner of Insurance is appointed by: The governor
20. 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?: Medicare supplement plan F
21. 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: Physical therapy
22. Twisting is best defined as: using misrepresentation to induce an insured
person to terminate an existing policy and purchase a new policy
23. The reinstatement provision in a health insurance policy is: Mandatory
