Nc State Law - Health Exam

52 Questions

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North Carolina Quizzes & Trivia

NC State Law


Questions and Answers
  • 1. 
    Policyowners who buy a health insurance policy issued in North Carolina are entitled to review the policy without obligation for at least how many days after it is delivered?
    • A. 

      7

    • B. 

      10

    • C. 

      21

    • D. 

      31

  • 2. 
    Which of the following is not considered a health benefit plan?
    • A. 

      HMO contract

    • B. 

      Accident and health insurance certificate

    • C. 

      Multiple employer welfare arrangement plan

    • D. 

      Medicare supplement policy

  • 3. 
    Which of the following entities would not be considered a health insurer in North Carolina?
    • A. 

      A hospital service corporation

    • B. 

      A health maintenance organization

    • C. 

      A group health plan

    • D. 

      A reciprocal insurer

  • 4. 
    • A. 

      Twisting

    • B. 

      False information

    • C. 

      Rebating

    • D. 

      Churning

  • 5. 
    Becky works as an agent for Delta Insurance Company, which is located in North Carolina. What must Becky do in order to sell life insurance on behalf of Delta to U.S. military personnel who are stationed in Germany?
    • A. 

      She must obtain a nonresident license.

    • B. 

      She must obtain a surplus lines agent's license.

    • C. 

      She must obtain a restricted license.

    • D. 

      Nothing, because she is already licensed as an agent.

  • 6. 
    Terry is licensed in North Carolina as a life and health insurance agent. To maintain his license, how many hours of continuing education must he complete every two years?
    • A. 

      12

    • B. 

      24

    • C. 

      30

    • D. 

      40

  • 7. 
    • A. 

      She must move to North Carolina.

    • B. 

      She must surrender her Maryland license.

    • C. 

      She must be sponsored by an agent licensed in North Carolina.

    • D. 

      She must show her license to be in good standing in Maryland.

  • 8. 
    An insurer must notify its current customers of its privacy policies or practices at least once every how often?
    • A. 

      6 months

    • B. 

      12 months

    • C. 

      18 months

    • D. 

      24 months

  • 9. 
    Harry is enrolled in a PPO and is currently seeing a health-care provider who does not participate in the plan. Which of the following statements is true?
    • A. 

      The PPO will deny all claims from the provider.

    • B. 

      The PPO will require Harry to pay higher copayments and deductibles if he sees a nonparticipating provider.

    • C. 

      The PPO will increase Harry's deductible if he sees a nonparticipating provider.

    • D. 

      The PPO may limit coverage if Harry receives health-care services from a nonparticipating provider.

  • 10. 
    Which of the following is not a power granted to the North Carolina Commissioner of Insurance?
    • A. 

      Examining insurers' financial statements

    • B. 

      Enforcing insurance laws

    • C. 

      Issuing regulations to administer insurance laws

    • D. 

      Prosecuting individuals for violating insurance laws

  • 11. 
    • A. 

      Larry, who receives insurance applications from the public

    • B. 

      Brian, who is a vice president in AllPro's human resources department and does not receive commissions

    • C. 

      Susan, who collects insurance premiums for AllPro

    • D. 

      Jennifer, who solicits insurance policies for AllPro and receives commissions

  • 12. 
    Which of the following is NOT an unfair claims settlement practice if committed by an insurance company in North Carolina?
    • A. 

      Failing to promptly acknowledge communications about claims

    • B. 

      Failing to promptly settle a claim for which liability is uncertain

    • C. 

      Offering to settle claims for less than due to encourage litigation

    • D. 

      Raising policy defenses to reduce a claim

  • 13. 
    When meeting with a prospect to discuss life insurance, Agent Tyler makes disparaging comments about the financial stability and reputation of a competitor to dissuade the prospect from purchasing its policies. Which unfair trade practice has Agent Tyler committed?
    • A. 

      Defamation

    • B. 

      Rebating

    • C. 

      Unfair discrimination

    • D. 

      Coercion

  • 14. 
    A franchise accident and health insurance policy may be issued to at least how many employees of a corporation?
    • A. 

      Two

    • B. 

      Three

    • C. 

      Five

    • D. 

      Ten

  • 15. 
    Acme Insurance and Apogee Insurance agree to offer different premium rates for persons of equal risk within a particular class. They also agree to limit benefits paid to insureds within this class if the insureds live in certain counties of North Carolina. What are Acme and Apogee engaging in?
    • A. 

      Acceptable marketing and underwriting practices

    • B. 

      Unfair and prohibited business practices

    • C. 

      Insurance fraud

    • D. 

      False advertising

  • 16. 
    Anthony is eligible for Medicaid and also eligible for coverage under his new employer's group health benefit plan. Which statement is correct?
    • A. 

      The employee benefit plan may limit his benefits because he is eligible for Medicaid.

    • B. 

      The employee benefit plan may deny him a policy.

    • C. 

      The employee benefit plan may not take into account the fact that Anthony is receiving Medicaid benefits when paying benefits.

    • D. 

      The employee benefit plan may require Anthony to pay a higher premium than other employees.

  • 17. 
    Which statement about the coverage of chemical dependency under a group health insurance policy is CORRECT?
    • A. 

      A group health insurance policy is required to cover treatment for chemical dependency.

    • B. 

      A group health insurance policy can provide different benefits for chemical dependency than for other illnesses.

    • C. 

      A group health insurance policy cannot set limits on the amount of benefits payable for chemical dependency.

    • D. 

      A group policyholder must have the option to purchase coverage for chemical dependency treatment.

  • 18. 
    Which type of limited policy will provide health insurance benefits when the insured or his dependents are hospitalized?
    • A. 

      Credit life and health policy

    • B. 

      Surplus lines policy

    • C. 

      Industrial health policy

    • D. 

      Hospitalization policy

  • 19. 
    Josephson Corporation will be offering a group health insurance policy this year to its employees. Which employee will not be eligible for coverage?
    • A. 

      Frank, who owns 50 percent of the company and works full-time

    • B. 

      Rachel, who works 30 hours per week in the accounting department

    • C. 

      Sebastian, who works part-time for the company during the fall and winter

    • D. 

      Anna, who is a vice president in the company and works 40 hours per week

  • 20. 
    Statewide Insurers wants to obtain an investigative consumer report about an applicant because of questions it has regarding the individual's credit history. What must Statewide do before it can obtain a report?
    • A. 

      Notify the applicant that he has the right to be interviewed in connection with the report

    • B. 

      Obtain the applicant's signed consent before obtaining the report

    • C. 

      Notify the applicant that he has the right to prepare his own report

    • D. 

      Require the applicant to sign an affidavit attesting to the truth of the statements in the report

  • 21. 
    A health insurance policy must pay benefits for services provided by all of the following EXCEPT:
    • A. 

      Optometrists

    • B. 

      Registered nurses

    • C. 

      Physician assistants

    • D. 

      Homeopathic practitioners

  • 22. 
    Emil, an agent licensed in North Carolina, moves to a new home on April 30. He is required to notify the North Carolina Department of Insurance by what date?
    • A. 

      May 7

    • B. 

      May 10

    • C. 

      May 30

    • D. 

      October 31

  • 23. 
    Delta Vacation Cruises wants to purchase group health coverage for its passengers. Which type of insurance should Delta purchase?
    • A. 

      Blanket policy

    • B. 

      Credit disability

    • C. 

      Illness only

    • D. 

      Accident and illness indemnity

  • 24. 
    Which of the following techniques is not used during the utilization review process?
    • A. 

      Second opinions

    • B. 

      Preventive care review

    • C. 

      Discharge planning

    • D. 

      Concurrent review

  • 25. 
    If a group health insurance policy terminates, an employee can elect to continue coverage provided he or she has been insured under the plan for how long before it terminates?
    • A. 

      3 months

    • B. 

      6 months

    • C. 

      9 months

    • D. 

      12 months

  • 26. 
    • A. 

      Notify individuals about the company’s privacy practices.

    • B. 

      Describe conditions under which the company may disclose the information to other parties.

    • C. 

      Provide methods for individuals to prevent disclosure of the information.

    • D. 

      Provide individuals with copies of documents disclosed to other parties.

  • 27. 
    Anthony becomes an agent for Acme Insurance Company. Acme has not filed the notice of appointment with the Commissioner. It must do so within how many days?
    • A. 

      10

    • B. 

      15

    • C. 

      30

    • D. 

      31

  • 28. 
    A claimant on a health insurance policy must give written notice of the claim to the insurer within how many days following a loss?
    • A. 

      7

    • B. 

      10

    • C. 

      14

    • D. 

      20

  • 29. 
    Before delivering a health insurance policy to a client, the agent alters the insuring clause in a way that he believes will benefit the insurance company. Which of the following statements is correct regarding this alteration?
    • A. 

      It is required of a diligent agent.

    • B. 

      It is prohibited by the entire contract provision.

    • C. 

      It is permitted only when it is in the insurer’s best interests.

    • D. 

      It is prohibited unless the insured agrees to it in writing.

  • 30. 
    Best Insurance Company is incorporated in Canada and just applied for a license to transact insurance in North Carolina. Which type of insurer is Best Insurance Company considered in North Carolina?
    • A. 

      Domestic

    • B. 

      Foreign

    • C. 

      Alien

    • D. 

      Limited

  • 31. 
    Bob had been working at Sunset Airlines for ten years when he was laid off on June 1. How long can Bob continue his health insurance coverage under Sunset's group plan?
    • A. 

      6 months

    • B. 

      9 months

    • C. 

      12 months

    • D. 

      18 months

  • 32. 
    Which of the following is not required to be covered under a group health insurance policy issued in North Carolina?
    • A. 

      Mammograms every year beginning at age 30

    • B. 

      Medicine and treatment for diabetes

    • C. 

      Prostate cancer screening tests

    • D. 

      Cervical cancer screening

  • 33. 
    • A. 

      Before disclosing information to law enforcement agencies who are investigating insurance fraud

    • B. 

      Before disclosing information in response to an administrative order

    • C. 

      Before disclosing information to third parties for telemarketing and sales purposes

    • D. 

      Before disclosing information to a consumer reporting agency

  • 34. 
    Blanket disability policies can be issued to all of the following EXCEPT:
    • A. 

      A common carrier, covering all passengers

    • B. 

      A school, covering students

    • C. 

      An employer, covering employees

    • D. 

      A family, covering family members

  • 35. 
    • A. 

      Ed, who had been working at RJ Industries for one month before his coverage terminated

    • B. 

      Myrna, whose coverage terminated due to nonpayment of premium

    • C. 

      Jane, whose former policy was replaced by another group policy two weeks after it terminated

    • D. 

      Ravi, who had been working at ABC Corporation for six years when the plan terminated because the insurer stopped offering plans in the state

  • 36. 
    The Commissioner of Insurance cannot suspend or revoke an agent’s license for which of the following reasons?
    • A. 

      Failing to meet projected sales goals

    • B. 

      Having an agent's license denied or suspended in another state

    • C. 

      Forging an individual's name on an insurance application

    • D. 

      Accepting insurance from an unlicensed individual

  • 37. 
    • A. 

      One-half of Jim's debt

    • B. 

      The total amount of Jim's debt

    • C. 

      The total amount of Jim's debt plus a premium for extra costs

    • D. 

      One-third of Jim's debt

  • 38. 
    Abby, age 66, just purchased an individual health insurance policy. On what basis can the insurer exclude coverage for diabetes, a condition that Abby was diagnosed with one year ago?
    • A. 

      The insurer can exclude coverage for up to six months.

    • B. 

      The insurer can exclude coverage for up to one year.

    • C. 

      The insurer may not exclude coverage for Abby's pre-existing condition.

    • D. 

      The insurer may limit coverage only if Abby's pre-existing condition was specifically defined in the policy.

  • 39. 
    Eric fails to pay the annual premium on his major medical insurance policy. The grace period provision allows him to pay the premium within how many days after the due date?
    • A. 

      7

    • B. 

      14

    • C. 

      21

    • D. 

      31

  • 40. 
    • A. 

      Agent Smith's license will be revoked.

    • B. 

      Agent Smith's license may be suspended for up to two years.

    • C. 

      Agent Smith can be sanctioned but not disciplined.

    • D. 

      Agent Smith will not be punished because he does not have a fiduciary duty to report the crime.

  • 41. 
    Bill believes he has a cause of action against his health insurer for itsrefusal to pay benefits on a claim. He filed written proof of loss on April1. Not having received a response by May 1, he decides to take legalaction. What will his attorney probably do?
    • A. 

      Advise him to file suit

    • B. 

      Advise him to wait

    • C. 

      Advise him to file proof of loss again

    • D. 

      Advise him to cancel the policy

  • 42. 
    • A. 

      From birth to the first birthday

    • B. 

      From birth to 30 days

    • C. 

      From birth to the end of the first calendar year

    • D. 

      From birth to the policy renewal date

  • 43. 
    Emily solicits policies and accepts premiums from the public but is notlicensed as an agent. She then turns over the applications andpremiums to her husband, who is licensed. Which statement is correct?
    • A. 

      Emily has committed a felony.

    • B. 

      Emily is not required to be licensed to solicit policies and accept premiums.

    • C. 

      Emily has not committed any type of unlawful act.

    • D. 

      Emily has committed a Class 1 misdemeanor.

  • 44. 
    • A. 

      An employee must provide evidence of insurability to convert to an individual policy.

    • B. 

      An employee must complete an application and pay the first premium within six months after coverage terminates.

    • C. 

      A person will not have the right to convert a policy if it was terminated due to nonpayment of premium.

    • D. 

      A person must prove that he or she is uninsurable to convert to an individual policy.

  • 45. 
    • A. 

      The new policy must cover individuals who were insured under the prior plan.

    • B. 

      The new policy may exclude individuals who were insured under the prior plan if they have preexisting conditions.

    • C. 

      The new policy may exclude individuals who were insured under the prior plan if they previously submitted claims for hospital confinement or pregnancy.

    • D. 

      The new policy may only exclude employees with claims exceeding specified levels from the new plan.

  • 46. 
    Which of the following persons would not qualify for a temporaryproducer’s license in North Carolina?
    • A. 

      Wife of a disabled producer

    • B. 

      Surviving spouse of a deceased producer

    • C. 

      Person designated by a producer on active military duty

    • D. 

      Parttime producer of a licensed agency

  • 47. 
    • A. 

      It is recommended when selling health insurance.

    • B. 

      It is prohibited at all times.

    • C. 

      It is required when selling to Medicare-eligible individuals.

    • D. 

      It is highly regulated by the Insurance Department.

  • 48. 
    To qualify for an insurance agent's license, a person must have all of thefollowing EXCEPT:
    • A. 

      College degree

    • B. 

      Good reputation and character

    • C. 

      Licensing fee

    • D. 

      18 years of age

  • 49. 
    Which of the following groups would typically NOT be eligible for groupaccident and health insurance?
    • A. 

      Association group

    • B. 

      Neighborhood group

    • C. 

      Labor union

    • D. 

      Employer group

  • 50. 
    Which type of insurance helps an insured pay off a loan if he or shebecomes disabled?
    • A. 

      Credit accident and health insurance

    • B. 

      Debtor accident and health insurance

    • C. 

      Double indemnity insurance

    • D. 

      Family maintenance insurance

  • 51. 
    Beatrice is a member of the Supreme Lodge fraternal benefit society.What must Beatrice do before she can sell insurance on its behalf?
    • A. 

      Obtain a restricted agent's license

    • B. 

      Obtain a surplus lines license

    • C. 

      Become a licensed agent with a specialty in fraternal lines insurance

    • D. 

      Comply with the same general licensing requirements that apply to resident agents

  • 52. 
    Liam's group health insurance policy terminated on February 1. Withinhow many days must he apply for a conversion policy and pay the firstpremium?
    • A. 

      15

    • B. 

      31

    • C. 

      60

    • D. 

      90