Page 1 of 116
NEW JERSEY ACCIDENT AND HEALTH INSURANCE
ACTUAL EXAM ALL 500 QUESTIONS AND CORRECT
ANSWERS LATEST UPDATE THIS YEAR
QUESTION: What does coinsurance mean?
- a policy covers the insured and the any additional named persons
-the insurer and the insured share expenses over the deductible
-the insurer and the insured share ALL expenses
-the policy owner holds multiple policies through the same insurer - ANSWER-The insurer and
the insured share expenses over the deductible
COINSURANCE IS THE SHARING BETWEEN THE INSURER AND THE INSURED OF COVERED
EXPENSES THAT EXCEED THE DEDUCTIBLE AMOUNT. THE SHARING ENDS WHEN THE "STOP
LOSS LIMIT" IS REACHED
QUESTION: The life insurance policy will not be truly effect until all of the following occur
EXCEPT:
-the statement of good health is obtained by the insurer
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, Page 2 of 116
-the first premium is collected
-the policy is delivered to the applicant
-the producer has explained the policy to the client - ANSWER--the producer has explained the
policy to the client
EFFECTIVE DATE BASED ON :
-APP DATE
-IF PREMIUM HAS BEEN PAID
-IF A STATEMENT OF GOOD HEALTH MUST BE OBTAINED IF PREMIUM WAS NOT SUBMITTED
WITH APPLICATION
QUESTION: Which of the following coverage types pays a monthly cash benefit following the
elimination period for total disability due to accident or sickness?
-credit disability
-works comp disability
-recurrent disability
-disability income - ANSWER--disability income insurance
2
, Page 3 of 116
Q; According to the Time Payment of Claims provision, the insurer must make the payment
immediately after receiving proof of loss EXCEPT:
- if the insured is able to eventually return to work
-if the death is suicide or due to a pre existing condition
-when the policy is in the incontestability period
-for claims involving periodic payments - ANSWER-for claims involving periodic payments
INSURERS MUST PAY LUMP SUM CLAIMS IMMEDIATELY AFTER RECEIVING PROOF OF LOSS
PROVIDES PAYMENT OF REGULAR PERIODIC INCOME SHOULD THE INSURED BECOME DISABLED
FROM ILLNESS OR INJURY
QUESTION: The period beginning at the time of an insured loss that an insured must wait
before benefits are payable is called the:
-probationary period
-benefit period
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, Page 4 of 116
-elimination period
-grace period - ANSWER--elimination period
THE TIME PERIOD STARTING AT THE TIME OF LOSS, SUCH AS A DISABILITY, THAT AN INSURED
MUST WAIT BEFORE BENEFITS ARE PAYABLE
QUESTION: Managed care plans increase efficiency by all of the following EXCEPT:
-transferring the management of costs to the insureds
-controlling inpatient admissions and length of stay
-increasing beneficiary cost sharing
-selectively contracting with health care providers - ANSWER--transferring the management of
costs to the insureds
MANAGED CARE PLANS ARE DESIGNED TO USE COST SAVING SERVICES BY USING CLOSED
NETWORKS AND MANAGING HEALTH CARE WITH THESE NETWORKS
4
NEW JERSEY ACCIDENT AND HEALTH INSURANCE
ACTUAL EXAM ALL 500 QUESTIONS AND CORRECT
ANSWERS LATEST UPDATE THIS YEAR
QUESTION: What does coinsurance mean?
- a policy covers the insured and the any additional named persons
-the insurer and the insured share expenses over the deductible
-the insurer and the insured share ALL expenses
-the policy owner holds multiple policies through the same insurer - ANSWER-The insurer and
the insured share expenses over the deductible
COINSURANCE IS THE SHARING BETWEEN THE INSURER AND THE INSURED OF COVERED
EXPENSES THAT EXCEED THE DEDUCTIBLE AMOUNT. THE SHARING ENDS WHEN THE "STOP
LOSS LIMIT" IS REACHED
QUESTION: The life insurance policy will not be truly effect until all of the following occur
EXCEPT:
-the statement of good health is obtained by the insurer
1
, Page 2 of 116
-the first premium is collected
-the policy is delivered to the applicant
-the producer has explained the policy to the client - ANSWER--the producer has explained the
policy to the client
EFFECTIVE DATE BASED ON :
-APP DATE
-IF PREMIUM HAS BEEN PAID
-IF A STATEMENT OF GOOD HEALTH MUST BE OBTAINED IF PREMIUM WAS NOT SUBMITTED
WITH APPLICATION
QUESTION: Which of the following coverage types pays a monthly cash benefit following the
elimination period for total disability due to accident or sickness?
-credit disability
-works comp disability
-recurrent disability
-disability income - ANSWER--disability income insurance
2
, Page 3 of 116
Q; According to the Time Payment of Claims provision, the insurer must make the payment
immediately after receiving proof of loss EXCEPT:
- if the insured is able to eventually return to work
-if the death is suicide or due to a pre existing condition
-when the policy is in the incontestability period
-for claims involving periodic payments - ANSWER-for claims involving periodic payments
INSURERS MUST PAY LUMP SUM CLAIMS IMMEDIATELY AFTER RECEIVING PROOF OF LOSS
PROVIDES PAYMENT OF REGULAR PERIODIC INCOME SHOULD THE INSURED BECOME DISABLED
FROM ILLNESS OR INJURY
QUESTION: The period beginning at the time of an insured loss that an insured must wait
before benefits are payable is called the:
-probationary period
-benefit period
3
, Page 4 of 116
-elimination period
-grace period - ANSWER--elimination period
THE TIME PERIOD STARTING AT THE TIME OF LOSS, SUCH AS A DISABILITY, THAT AN INSURED
MUST WAIT BEFORE BENEFITS ARE PAYABLE
QUESTION: Managed care plans increase efficiency by all of the following EXCEPT:
-transferring the management of costs to the insureds
-controlling inpatient admissions and length of stay
-increasing beneficiary cost sharing
-selectively contracting with health care providers - ANSWER--transferring the management of
costs to the insureds
MANAGED CARE PLANS ARE DESIGNED TO USE COST SAVING SERVICES BY USING CLOSED
NETWORKS AND MANAGING HEALTH CARE WITH THESE NETWORKS
4
