Simulated Exam

after a sudden death of producer M, his business partner, who is not a licensed producer, finds another producer who is willing to continue servicing the policies of M's clients. this agreement can last no longer than: -30 days -90 days -180 days -365 days

180 days

under the New Jersey Temporary Disability Law, a "covered individual" is any person who is employed by a covered employer, or who has been out of work for less than: -2 weeks -4 weeks -1 week -3 weeks

2 weeks

insurers must maintain files containing all of their advertisements for: -5 years -2 years -3 years -4 years

5 years

in a 12-month period, how many home health care visits must health insurance policy provide for: -90 -120 -30 -60

60

what is the minimum age for Medicare supplement policy coverage: -55 -60 -65 -70

65

how can a new physician be added to the PPO's approved list: -pay an annual fee for being on the PPO list -new physicians are only added once a year, and are selected by the PPO's Board of Directors -agree to follow the PPO standards and charge the appropriate fees -fill out the appropriate paperwork and wait the 12 month pre-certification period

agree to follow the PPO standards and charge the appropriate fees

which of the following is not a feature of a noncancellable policy: -the insurer may terminate the contract only at renewal for certain conditions -the premiums cannot be increased beyond the amount stated in the policy -the guarantee to renew coverage usually applies until the insured reaches a certain age -the insured has the right to renew the policy for the life of the contract

the insurer may terminate the contract only at renewal for certain conditions

a policy with a 31-day grace period implies: -the policy benefits must be paid within 31 days after a claim is submitted -the policy will not lapse for 31 days if the premium is not paid when due -the policyholder may return the policy for a full refund within 31 days -the policy is incontestable after 31 days of delivery

the policyholder may return the policy for a full refund within 31 days

regarding Medicare SELECT policies, what are restricted network provisions: -they determine premium rates -they help avoid adverse selectio -they condition the payment of benefits -they condition the payment of benefits -they determine who can be insured

they condition the payment of benefits

in accordance with the Administrative Procedure Act, what entity has the authority to make and enforce rules and regulations to implement and carry out the purposes of the insurance laws of NJ: -Insurance Regulation Board -Commissioner -governor -NAIC

Commissioner

the Commissioner believes that a licensee has violated an insurance regulation and decides to conduct a hearing. how long of a notice must the Commissioner provide the licensee: -10 days -14 days -20 days -31 days

10 days

the Commissioner believes that an insurance rule or regulation has been violated & decides to call a disciplinary hearing. how many days before a hearing must the Commissioner issue a notice to the person charged with the violation: -20 days -30 days -7 days -10 days

10 days

if an applicant's license has lapsed within the past year, the applicant may apply for late renewal of the license within the maximum of how many months of expiration: -3 months -6 months -9 months -12 months

12 months

if an insurer cancels an agency contract, it must notify the Commissioner in writing within how many days: -10 -15 -20 -30

15 days

what percentage of eligible employees must participate on a small employer group health insurance plan: -25% -50% -75% -100%

75%

which of the following statements is not correct concerning the COBRA act of 1985: -covers terminated employees and or their dependents for up to 36 months after a qualifying event -applies only to employers with 20 or more employees that maintain group health insurance plans for employees -COBRA stands for Coordination Omnibus Budget Reconciliation Act -requires all employers, regardless of the number or age of employees, to provide extended group health coverage

applies to employers with 20 or more employees that maintain group health insurance plans for employees

what is the maximum period of time during which an insurer may contest fraudulent misstatements made in a health insurance application: -90 days after the effective policy date -6 months after the effective policy date -1 year after the effective policy date -as long as the policy is in force

as long as the policy is in force

the provision that provides for the sharing of expenses between the insured and the insurance company is: -deductible -dividend cost -coinsurance -stop loss

coinsurance

if an insurer and insured have a dispute about whether a particular loss is covered under a policy, which authority will settle the dispute: -consumer protection agency -court system -commissioner -federal insurance regulation board

court system

which of the following is not an exclusion in medical expense insurance policies: -self inflicted injuries -routine dental care -coverage for dependents -military duty

coverage for dependents

an insured is covered by a disability income policy that contains an accidental means clause. the insured exits a bus by jumping down the steps and breaks an ankle. what coverage will apply: -no coverage; since the injury could have been foreseen -no coverage; disability income policies cover sickness only -coverage; break was accidental -coverage; but reduced to 50%

coverage; break was accidental

which of the following best describes the purpose of Coordination of Benefits regulations: -discourage people form purchasing temp insurance or dread disease plans -allow people who are Insured under two or more health plans to collect full benefits from each plan -encourage people to purchase two or more plans by allowing duplication of benefits under certain circumstances -discourage overinsurance and avoid duplication of benefits by permitting a reduction of benefits when a person is covered by more than one plan

discourage overinsurance and avoid duplication of benefits by permitting a reduction of benefits when a person is covered by more than one plan

in a disability policy, the probationary period refers to the time: -between the 10th day of an illness-related disability and the first payment -between the first disability and the actual receipt of payment for the disability incurred -during which illness-related disabilities are excluded from coverage -between the first day of disability and the day the disability must continue before the insured received any benefits

during which illness-related disabilities are excluded from coverage

another term used to describe "no deductible" is: -total coverage -immediate coverage -first dollar basis -comprehensive

first-dollar basis

a licensed insurance producer may request a waiver of license renewal procedures under any of the following circumstances except: -he has recently been confined to a wheelchair due to MS -he was injured in a car accident -he has been called into active duty -his renewal forms were lost in the mail

his renewal forms were lost in the mail

a health insurance policy lapses but is reinstated within an acceptable timeframe. how soon from the reinstatement date will coverage for accidents become effective: -immediately -after 14 days -after 21 days -after 31 days

immediately

in the event of loss, after notice of claim is submitted to the insurer, who is responsible for providing claims forms and to which party: -insurer to the insured -insured to the insurer -insurer to the Department of Insurance -insured to the Department of Insurance

insurer to the insured

what significance did U.S vs South Eastern Underwriters have on the insurance industry: -it determined that insurance licenses should no longer be issued by the FEDS and should instead be issued by the states -it determined that insurance licenses should no longer be issued by individual states and should instead be issued by the FEDS -it reversed the decision of Paul vs Virginia, determining that insurance is interstate commerce and should be regulated federally -it reversed the decision of Paul vs Virginia, determining that insurance is not interstate commerce and should be not regulated federally

it reversed the decision of Paul vs Virginia, determining that insurance is interstate commerce and should be regulated federally

which of the following most likely would not be required to complete continuing education hours in this state: -insurance brokers -resident producers -nonresident producers -insurance consultants

nonresident producers

all of the following are true regarding Key Employee Disability Income insurance except: -premiums are not tax deductible for the employer -benefits are taxable to the employer -the employer owns the policy -benefits are paid to the employer to retrain a new person

premiums are tax deductible to the employer

all of the following are true regarding rebates except: -dividends are not considered to be rebates -rebates are allowed if it is in the best interest of the client -rebates are only allowed if specifically stated in the policy -rebating can be anything of monetary value given as an inducement to purchase insurance

rebates are only allowed if it is in the best interest of the client

which of the following is not provided by an HMO: -services -financing -patient care -remibursement

reimbursement

an insured has endured multiple surgeries and hospitalizations for an illness during the last few months. her insurer no longer bills her for medical expenses. which of the following allows for that: -grace period -waiver of premium -maximum limit -stop loss

stop loss limit