NJ Health and Accident EXAM STUDY
GUIDE 2026/2027 COMPLETE QUESTIONS
WITH CORRECT DETAILED ANSWERS ||
100% GUARANTEED PASS
<LATEST VERSION>
In what form do disability income policies typically pay benefits - ANSWER
Periodic income
The Mandatory health policy provision states that the policy, including
endorsements and attached papers, constitutes - ANSWER The entire insurance
contract between the parties
The entire contract includes the actual policy and the - ANSWER application
employer sponsored group health insurance provides coverage for which of the
following - ANSWER Alcoholism
The term which describes the fact that both parties of a contract may not receive
the same value is referred to as - ANSWER Aleatory
Tom has a home health care benefit and is confined to his home. Which of these is
NOT typically covered - ANSWER Full-time nursing care
A Medicare Supplement policy can be cancelled by the insurer for - ANSWER
Nonpayment
, Credit Accident and Health plans are designed to - ANSWER help pay off
existing loans during periods of disability
A payment system for health care in which the provider is paid for each service
given is called - ANSWER fee-for-service
An insurance company ONLY pay a sales commission to - ANSWER individuals
licensed by the state
Ken is a producer who has obtained Consumer Information Reports under false
pretenses. Under the Fair Credit Reporting Act, what is the maximum penalty that
may be imposed on Ken? - ANSWER $5000 and 1 year imprisonment
A closed network plan offers a primary physician copay of $25. If a subscriber
chooses a primary care physician outside of the network, the subscriber will likely
pay - ANSWER 100% of the billed amount
What is the maximum fine for a producer violating an NJ insurance law for the
first time? - ANSWER $5000
What does the Consolidated Omnibus Budget Reconciliation Act (COBRA) of
1985 allow an employee to do? - ANSWER In the event of employment
termination, group health insurance can be kept if the employee pays the premiums
Replacement regulation is designed to protect the interests of - ANSWER Policy
owners
Continued coverage under COBRA would be provided to all of the following
except? - ANSWER a covered employee is terminated for gross misconduct
,A health insurer must be provided with written proof of loss ______ days after the
date of loss - ANSWER 90 days
All of the following are factors would affect a health insurance policies premium
rate Except - ANSWER Residential address of the insured
Which of the following is NOT a required provision in an accident and health
insurance policy? - ANSWER Change of occupation (considered optional
provision)
Within how many days must a producer notify the Department of Banking and
Insurance of a change in address? - ANSWER 30 days
When comparing an HMO, to a PPO, the PPO - ANSWER provides a greater
choice of providers
Under the Consolidated Omnibus Budget Reconciliation Act (COBRA), a
terminated employee's benefits must - ANSWER be the same and the premium
cannot exceed 102%
An agent is required to keep replacement forms on file for at LEAST ______
years. - ANSWER 5 years
An insurer has the right to recover a payment made to the insured from the
negligent party. These rights are called - ANSWER Subrogation
All advertisements for health insurance shall make clear the identity of the -
ANSWER insurer
, Bill requires some nursing care and supervision but NOT full-time care. Which of
these nursing home options would best serve him? - ANSWER Assisted living
How many employees must an employer have for a terminated employee to be
eligible for COBRA? - ANSWER 20
An agent has committed an insurance crime that violates US CODE 1033
(interstate commerce). Who would be responsible for the prosecution of this
crime? - ANSWER US Attorney General
The time limit for filing claim disputes is addressed in which provision of an
accident and health policy? - ANSWER Legal actions
What is the process for a producer voluntarily terminating his/her license? -
ANSWER Returning his/her license to the Banking and Insurance Department
Under the Health Insurance Portability and Accountability Act (HIPAA), the
employee's new Group Health Plan will verify Creditable Coverage so that the -
ANSWER employee's waiting period for coverage of a preexisting condition can
be reduced under the new employer's health plan
At what age will a person normally enroll with an insurance carrier under a Part C
Medicare Advantage Plan? - ANSWER Age 65
Under group health insurance, a certificate of coverage is issued to the -
ANSWER Employee
GUIDE 2026/2027 COMPLETE QUESTIONS
WITH CORRECT DETAILED ANSWERS ||
100% GUARANTEED PASS
<LATEST VERSION>
In what form do disability income policies typically pay benefits - ANSWER
Periodic income
The Mandatory health policy provision states that the policy, including
endorsements and attached papers, constitutes - ANSWER The entire insurance
contract between the parties
The entire contract includes the actual policy and the - ANSWER application
employer sponsored group health insurance provides coverage for which of the
following - ANSWER Alcoholism
The term which describes the fact that both parties of a contract may not receive
the same value is referred to as - ANSWER Aleatory
Tom has a home health care benefit and is confined to his home. Which of these is
NOT typically covered - ANSWER Full-time nursing care
A Medicare Supplement policy can be cancelled by the insurer for - ANSWER
Nonpayment
, Credit Accident and Health plans are designed to - ANSWER help pay off
existing loans during periods of disability
A payment system for health care in which the provider is paid for each service
given is called - ANSWER fee-for-service
An insurance company ONLY pay a sales commission to - ANSWER individuals
licensed by the state
Ken is a producer who has obtained Consumer Information Reports under false
pretenses. Under the Fair Credit Reporting Act, what is the maximum penalty that
may be imposed on Ken? - ANSWER $5000 and 1 year imprisonment
A closed network plan offers a primary physician copay of $25. If a subscriber
chooses a primary care physician outside of the network, the subscriber will likely
pay - ANSWER 100% of the billed amount
What is the maximum fine for a producer violating an NJ insurance law for the
first time? - ANSWER $5000
What does the Consolidated Omnibus Budget Reconciliation Act (COBRA) of
1985 allow an employee to do? - ANSWER In the event of employment
termination, group health insurance can be kept if the employee pays the premiums
Replacement regulation is designed to protect the interests of - ANSWER Policy
owners
Continued coverage under COBRA would be provided to all of the following
except? - ANSWER a covered employee is terminated for gross misconduct
,A health insurer must be provided with written proof of loss ______ days after the
date of loss - ANSWER 90 days
All of the following are factors would affect a health insurance policies premium
rate Except - ANSWER Residential address of the insured
Which of the following is NOT a required provision in an accident and health
insurance policy? - ANSWER Change of occupation (considered optional
provision)
Within how many days must a producer notify the Department of Banking and
Insurance of a change in address? - ANSWER 30 days
When comparing an HMO, to a PPO, the PPO - ANSWER provides a greater
choice of providers
Under the Consolidated Omnibus Budget Reconciliation Act (COBRA), a
terminated employee's benefits must - ANSWER be the same and the premium
cannot exceed 102%
An agent is required to keep replacement forms on file for at LEAST ______
years. - ANSWER 5 years
An insurer has the right to recover a payment made to the insured from the
negligent party. These rights are called - ANSWER Subrogation
All advertisements for health insurance shall make clear the identity of the -
ANSWER insurer
, Bill requires some nursing care and supervision but NOT full-time care. Which of
these nursing home options would best serve him? - ANSWER Assisted living
How many employees must an employer have for a terminated employee to be
eligible for COBRA? - ANSWER 20
An agent has committed an insurance crime that violates US CODE 1033
(interstate commerce). Who would be responsible for the prosecution of this
crime? - ANSWER US Attorney General
The time limit for filing claim disputes is addressed in which provision of an
accident and health policy? - ANSWER Legal actions
What is the process for a producer voluntarily terminating his/her license? -
ANSWER Returning his/her license to the Banking and Insurance Department
Under the Health Insurance Portability and Accountability Act (HIPAA), the
employee's new Group Health Plan will verify Creditable Coverage so that the -
ANSWER employee's waiting period for coverage of a preexisting condition can
be reduced under the new employer's health plan
At what age will a person normally enroll with an insurance carrier under a Part C
Medicare Advantage Plan? - ANSWER Age 65
Under group health insurance, a certificate of coverage is issued to the -
ANSWER Employee
