NORTH CAROLINA HEALTH INSURANCE STATE EXAM PREP QUESTIONS AND ANSWERS
2025
Insured Contingent Beneficiary - (ANSWER)If the insured and primary beneficiary are both killed in the
same accident and it cannot be determined who died first, where are the death proceeds to be directed
under the uniform Simultaneous Death Act?
Reimbursement - (ANSWER)Which type of policy pays benefits to a policyholder covered under a
Hospital Expense policy?
$25,000 - (ANSWER)J has an Accidental Death and Dismemberment policy with a principal sum of
$50,000. While trimming the hedges, J cuts off one of his fingers. What is the MAXIMUM J will receive
from his policy?
payable to the company or another shareholder - (ANSWER)The benefits under a Disability Buy-Out
policy are:
off-the -job accident - (ANSWER)An accident policy will most likely pay a benefit for a(n)
indemnity - (ANSWER)a payment for damage or loss
continue group health benefits - (ANSWER)The COBRA gives workers whose employment has been
terminated the right to
Social Security Disability Income - (ANSWER)The percentage of as individual's Primary Insurance Amount
determines the benefits paid in which of the following programs.
100% of the insured's Primary Insurance Amount (PIA) - (ANSWER)What is the maximum Social Security
Disability benefit amount an insured can receive?
PPO's are NOT a type of managed care system - (ANSWER)Which of these statements is INCORRECT
regarding a PPO?
, NORTH CAROLINA HEALTH INSURANCE STATE EXAM PREP QUESTIONS AND ANSWERS
2025
Part A covers hospitalization; Part B covers doctor's services - (ANSWER)What does Medicare Parts A
and B cover?
PPO - (ANSWER)Under what system do a group of doctors and hospitals in a designated area contract
with an insurer to provide services at a prearranged cost to the insured?
closed panel - (ANSWER)The situation in which a group of physicians are salaried employees and
conduct business in an HMO facility is called a(n)
Her group health plan (if the employer has more than 20 employees, the group health plan generally
pays first) - (ANSWER)A 66 year-old is covered under a group health plan while employed with a
business that has 40 employees. If she injures herself while walking in the park, what coverage would be
considered primary?
Commercial Insurers - (ANSWER)Which of the following reimburses its insureds for covered medical
expenses?
If the employee paid for qualified medical expenses, the reimbursements may be tax-free -
(ANSWER)Which of the following statements about Health Reimbursement Arrangements (HRA) is
CORRECT?
Restoration of used benefit - (ANSWER)Which provision allows a portion of any used medical benefits to
be restored following a particular amount of benefit has been used, or after the policy has been in effect
for a particular period of time?
Common Accident Deductible - (ANSWER)If several family members are injured in the same accident,
only one deductible is applied.
$1,600 - (ANSWER)M has a Major Medical Insurance policy with a $200 flat deductible and an 80%
Coinsurance clause. If M incurs a $2,200 claim for an eligible medical expense, how much will M receive
in payment for this claim?
2025
Insured Contingent Beneficiary - (ANSWER)If the insured and primary beneficiary are both killed in the
same accident and it cannot be determined who died first, where are the death proceeds to be directed
under the uniform Simultaneous Death Act?
Reimbursement - (ANSWER)Which type of policy pays benefits to a policyholder covered under a
Hospital Expense policy?
$25,000 - (ANSWER)J has an Accidental Death and Dismemberment policy with a principal sum of
$50,000. While trimming the hedges, J cuts off one of his fingers. What is the MAXIMUM J will receive
from his policy?
payable to the company or another shareholder - (ANSWER)The benefits under a Disability Buy-Out
policy are:
off-the -job accident - (ANSWER)An accident policy will most likely pay a benefit for a(n)
indemnity - (ANSWER)a payment for damage or loss
continue group health benefits - (ANSWER)The COBRA gives workers whose employment has been
terminated the right to
Social Security Disability Income - (ANSWER)The percentage of as individual's Primary Insurance Amount
determines the benefits paid in which of the following programs.
100% of the insured's Primary Insurance Amount (PIA) - (ANSWER)What is the maximum Social Security
Disability benefit amount an insured can receive?
PPO's are NOT a type of managed care system - (ANSWER)Which of these statements is INCORRECT
regarding a PPO?
, NORTH CAROLINA HEALTH INSURANCE STATE EXAM PREP QUESTIONS AND ANSWERS
2025
Part A covers hospitalization; Part B covers doctor's services - (ANSWER)What does Medicare Parts A
and B cover?
PPO - (ANSWER)Under what system do a group of doctors and hospitals in a designated area contract
with an insurer to provide services at a prearranged cost to the insured?
closed panel - (ANSWER)The situation in which a group of physicians are salaried employees and
conduct business in an HMO facility is called a(n)
Her group health plan (if the employer has more than 20 employees, the group health plan generally
pays first) - (ANSWER)A 66 year-old is covered under a group health plan while employed with a
business that has 40 employees. If she injures herself while walking in the park, what coverage would be
considered primary?
Commercial Insurers - (ANSWER)Which of the following reimburses its insureds for covered medical
expenses?
If the employee paid for qualified medical expenses, the reimbursements may be tax-free -
(ANSWER)Which of the following statements about Health Reimbursement Arrangements (HRA) is
CORRECT?
Restoration of used benefit - (ANSWER)Which provision allows a portion of any used medical benefits to
be restored following a particular amount of benefit has been used, or after the policy has been in effect
for a particular period of time?
Common Accident Deductible - (ANSWER)If several family members are injured in the same accident,
only one deductible is applied.
$1,600 - (ANSWER)M has a Major Medical Insurance policy with a $200 flat deductible and an 80%
Coinsurance clause. If M incurs a $2,200 claim for an eligible medical expense, how much will M receive
in payment for this claim?
