NORTH CAROLINA HEALTH INSURANCE LICENSE TEST 2025
PREPARATION TEST BANK WITH 200 QUESTIONS AND CORRECT
DETAILED ANSWERS FOR ACTUAL EXAM PRACTICE| NC HEALTH
INSURANCE EXAM PREP TEST BANK
A husband and wife are insured under group health insurance plans at their own places of employment,
and as dependents under their spouse's coverage. If one of them incurs hospital expenses, how will
those expenses likely be paid?
a)Neither plan would pay.
b)Each plan will pay in equal shares.
c)The insured will have to select a plan from which to collect benefits.
d)The benefits will be coordinated. - CORRECT ANSWERS-d)The benefits will be coordinated.
Benefits will be coordinated when individuals are covered under two or more health plans.
After appointing an agent, how long does an insurer have to file with the Commissioner the form
detailing the agent's name, address, and other needed information?
A) 15 days
B) 30 days
C) 45 days
D) 60 days - CORRECT ANSWERS-B) 30 days
Insurers have 30 days to file, in a form prescribed by the Commissioner, the names, addresses, and other
information required by the Commissioner for its newly appointed agents.
Bethany studies in England for a semester. While she is there, she is involved in a train accident that
leaves her disabled. If Bethany owns a general disability policy, what will be the extent of benefits that
she receives? - CORRECT ANSWERS-None
,Which of the following are the main factors taken into account when calculating residual disability
benefits?
a)Present earnings and earnings prior to disability
b)Earnings prior to disability and the length of disability
c)Employee's full-time status and length of disability
d)Present earnings and standard cost of living - CORRECT ANSWERS-a)Present earnings and
earnings prior to disability
Residual disability will help pay for loss of earnings by making up the difference between the employee's
present earnings and what they were earning prior to disability.
How can a new physician be added to the PPO's approved list?
a)Fill out the appropriate paperwork and wait the 12 month pre-certification period.
b)Pay an annual fee for being on the PPO list.
c)New physicians are only added once a year, and are selected by the PPO's Board of Directors.
d)Agree to follow the PPO standards and charge the appropriate fees. - CORRECT ANSWERS-
d)Agree to follow the PPO standards and charge the appropriate fees.
Any physician or hospital that qualifies for and agrees to follow the PPO's standards and charges the
established fees can be added to the PPO's approved list at any time. The providers may withdraw their
name from the list at any time, as well.
Under the uniform required provisions, proof of loss under a health insurance policy normally should be
filed within
a)90 days of a loss.
b)20 days of a loss.
c)30 days of a loss.
, d)60 days of a loss. - CORRECT ANSWERS-a)90 days of a loss.
Under the Uniform Required Provisions, proof of loss under a health insurance policy normally should be
filed within 90 days of a loss.
Which of the following must an insurer obtain in order to transact insurance within a given state?
a)Business entity license
b)Insurer's license
c)Certificate of authority
d)Producer's certificate - CORRECT ANSWERS-c)Certificate of authority
All insurers (domestic, foreign, or alien) must obtain a certificate of authority before transacting
insurance within a given state.
According to the Future Increase Option Rider (FIO), which of the following is NOT a qualifying event to
increase an insured's benefit level?
a)Death of a spouse
b)Age 40
c)Marriage
d)Birth of a child - CORRECT ANSWERS-a)Death of a spouse
The FIO rider allows insureds to increase their benefit levels to certain amounts at specific times without
proof of insurability. The following are the typical occasions when an insurer allows for a benefit
increase: ages 25, 28, 31, 34, 37 and 40; marriage; and the birth of a child.
If an insurer accepts premium payments by credit card, who is responsible for paying the fees charged by
a credit card company?
a)Policyowners, as part of their premium
PREPARATION TEST BANK WITH 200 QUESTIONS AND CORRECT
DETAILED ANSWERS FOR ACTUAL EXAM PRACTICE| NC HEALTH
INSURANCE EXAM PREP TEST BANK
A husband and wife are insured under group health insurance plans at their own places of employment,
and as dependents under their spouse's coverage. If one of them incurs hospital expenses, how will
those expenses likely be paid?
a)Neither plan would pay.
b)Each plan will pay in equal shares.
c)The insured will have to select a plan from which to collect benefits.
d)The benefits will be coordinated. - CORRECT ANSWERS-d)The benefits will be coordinated.
Benefits will be coordinated when individuals are covered under two or more health plans.
After appointing an agent, how long does an insurer have to file with the Commissioner the form
detailing the agent's name, address, and other needed information?
A) 15 days
B) 30 days
C) 45 days
D) 60 days - CORRECT ANSWERS-B) 30 days
Insurers have 30 days to file, in a form prescribed by the Commissioner, the names, addresses, and other
information required by the Commissioner for its newly appointed agents.
Bethany studies in England for a semester. While she is there, she is involved in a train accident that
leaves her disabled. If Bethany owns a general disability policy, what will be the extent of benefits that
she receives? - CORRECT ANSWERS-None
,Which of the following are the main factors taken into account when calculating residual disability
benefits?
a)Present earnings and earnings prior to disability
b)Earnings prior to disability and the length of disability
c)Employee's full-time status and length of disability
d)Present earnings and standard cost of living - CORRECT ANSWERS-a)Present earnings and
earnings prior to disability
Residual disability will help pay for loss of earnings by making up the difference between the employee's
present earnings and what they were earning prior to disability.
How can a new physician be added to the PPO's approved list?
a)Fill out the appropriate paperwork and wait the 12 month pre-certification period.
b)Pay an annual fee for being on the PPO list.
c)New physicians are only added once a year, and are selected by the PPO's Board of Directors.
d)Agree to follow the PPO standards and charge the appropriate fees. - CORRECT ANSWERS-
d)Agree to follow the PPO standards and charge the appropriate fees.
Any physician or hospital that qualifies for and agrees to follow the PPO's standards and charges the
established fees can be added to the PPO's approved list at any time. The providers may withdraw their
name from the list at any time, as well.
Under the uniform required provisions, proof of loss under a health insurance policy normally should be
filed within
a)90 days of a loss.
b)20 days of a loss.
c)30 days of a loss.
, d)60 days of a loss. - CORRECT ANSWERS-a)90 days of a loss.
Under the Uniform Required Provisions, proof of loss under a health insurance policy normally should be
filed within 90 days of a loss.
Which of the following must an insurer obtain in order to transact insurance within a given state?
a)Business entity license
b)Insurer's license
c)Certificate of authority
d)Producer's certificate - CORRECT ANSWERS-c)Certificate of authority
All insurers (domestic, foreign, or alien) must obtain a certificate of authority before transacting
insurance within a given state.
According to the Future Increase Option Rider (FIO), which of the following is NOT a qualifying event to
increase an insured's benefit level?
a)Death of a spouse
b)Age 40
c)Marriage
d)Birth of a child - CORRECT ANSWERS-a)Death of a spouse
The FIO rider allows insureds to increase their benefit levels to certain amounts at specific times without
proof of insurability. The following are the typical occasions when an insurer allows for a benefit
increase: ages 25, 28, 31, 34, 37 and 40; marriage; and the birth of a child.
If an insurer accepts premium payments by credit card, who is responsible for paying the fees charged by
a credit card company?
a)Policyowners, as part of their premium
