Health Chapter 10 Exam - NJ Laws and Rules
Health insurance advertisements that mention statistical information are required by NJ law to
Accurately convey all pertinent facts
Which of the following are retained at the expense of an insurance buyer to give advice on insurance needed by the buyer? Brokers and consultants Insurance prospectors Third-party adminstrators Agents
Brokers and consultants
The commissioner issues a subpoena to a producer. The producer decides not to respond. Which course of action must be taken by the Commissioner?
Commissioner may impose an administrative penalty
Continuing Education credits may be approved for which of the following?
Ethics
The New Jersey Life and Health Insurance Guaranty Association is
Funded by assessments on member companies
An insurance producer is issued a(n) ____ as evidence of authority
License
A buyer's guide and policy summary
Must be delivered with or prior to the policy delivery
Which of the following is MANDATORY coverage for all group health care service contracts? Treatment for alcoholism Short-term disability Custodial care Dental Care
Treatment for alcoholism
A Buyer's Guide MUST
Contain content approved by the Commissioner
In New Jersey, health insurance advertisements are required to contain the
Insurance company's name
An agent is required to keep replacement forms on file for at LEAST ____ years
5
NJ insurance law requires eligible individuals to make an election to continue health insurance benefits with a MAXIMUM of ____ days after coverage termination
60
In NJ, group health insurance may be offered to all these groups EXCEPT private employer city government college seminar participants small employer
college seminar participants
After passing the state Producer licensing exam, application for the license must be made within
12 months
How old must an individual be to obtain a producer's license?
18
A newborn is required to be covered for ___ days from the moment of birth
30
Which of the following is NOT a duty of the Commissioner? Establish insurer rates Conduct investigations Issue Subpoenas Adminster oaths
Establish insurer rates
If an insurer receives a Notice of Claim under an individual health policy and fails to provide proof of loss forms within 15 days, the insured must?
File a written proof of loss, detailing the occurrence, character and extent of the loss
The law that established insurance transactions should be regulated by the states is called the
McCarran-Ferguson Act
Which of the following MUST contain a "Statement of Policy Cost and Benefit Information"?
Policy summary
Replacement regulation is designed to protect the interests of
Policyowners
The New Jersey Temporary Disability Benefits law
Provides non-occupational disability benefits
In the health insurance policy, when should the written notice of claim be given to the insurer?
Within 20 days after the occurrence or commencement of any loss covered by the policy
Which of the following is an example of defamation? Using intimidation in order to restrain or monopolize the business of insurance Using derogatory statements about an insurance company's financial condition Returning a portion of a premium as inducement to purchase insurance Offering a client something of value not stated in the contract in exchange for their business
Using derogatory statements about an insurance company's financial condition
Which of the following situations would be suitable for a temporary work authority? When a producer's license is suspended and an appeal date is set When an applicant completes an approved prelicensing course When an applicant passes a licensing examination and answers all background questions negatively When an applicant fails the licensing examination and is waiting to take another test
When an applicant passes a licensing examination and answers all background questions negatively
An insurance company that is organized or chartered in a country other than the United States is defined as
Alien
Which of these may NOT be used in a health insurance advertisement? A celebrity endorsement A statement that highlights coverage amounts A paid testimonial An insurance company's trademark instead of the company's actual name
An insurance company's trademark instead of the company's actual name
A(n) ____ insurance company is one that was formed under the laws of a state other than NJ
Foreign
Nina just passed her NJ insurance licensing examination. She is REQUIRED to apply for a producer's license within ____ months
12
Once an accident and health insurance policy has been in force for ___ year(s), the policy may not be contested by the insurer
2
Knowingly making misleading statements that would cause an insured to lapse, assign, or terminate an insurance policy in order to switch companies is an example of
Twisting
A producer must notify the Commissioner within ___ days of a felony conviction
30
The replacement of an existing insurance policy requires notice that the owner can return the policy within ___ days for a full refund
30
Under the NJ continuance of benefits law, notice to extend coverage is required within how many days of a qualifying event?
30
Within how many days must a producer notify the department of banking and insurance of a change in address?
30
Pierre the producer receives a premium for an individual health insurance policy. Pierre MUST remit the premium to his insurer within ____ business days of receipt
7
Which of the following is NOT contained in a certification of license status? Licensee's place of birth License authorities granted License expiration date License reference number
Licensee's place of birth
An insurance company may ONLY pay a sales commission to
Individuals licensed by the state
The Commissioner of Insurance is appointed by which of the following? The legislature The senate The secretary of state The governor
The governor
