NY-Life-Accident-and-Health Insurance Licensing New York Life, Accident and Health Insurance Agent/Broker Examination Series 17-55 Free Practice Exam Questions (2026 Updated)

The free-look provision in life insurance policies allows a policyowner a specific period after receiving the policy to review the contract and decide whether to keep it. During this period, the policyowner may return the policy to the insurer or the agent and receive a full refund of any premium paid , with the contract treated as if it had never been issued. For most life insurance policies, the standard free-look period used by the majority of insurers is 10 days , making B the correct answer.

The purpose of the free-look provision is to protect consumers by giving them time to carefully review the policy provisions, benefits, exclusions, riders, and premium obligations after delivery. If the policyholder finds that the policy does not meet their expectations or financial needs, they can cancel without penalty during the free-look timeframe.

In many licensing materials and insurer training programs, including those aligned with New York Life Accident and Health study outlines, 10 days is the commonly tested free-look period for traditional life insurance policies. Some situations—such as replacement policies or certain senior policies—may allow longer review periods depending on state regulations, but 10 days remains the standard benchmark used in exam questions.

Medicare Supplement insurance (Medigap) is designed to fill gaps in Original Medicare (Parts A and B) by paying certain out-of-pocket expenses that Medicare does not pay in full. A commonly tested basic Medigap benefit is coverage for the first 3 pints of blood each year . Under Original Medicare, a beneficiary may be responsible for the cost of the first three pints of blood in a calendar year (unless replaced or covered under specific circumstances). Medigap policies include this “first three pints” coverage as part of the standardized core benefits, helping reduce the beneficiary’s exposure to unexpected hospital or outpatient blood costs.

The other choices are not considered standard “basic” Medigap benefits. “At-home recovery” and certain “preventive care” enhancements have been associated with limited or older plan designs rather than being universally basic. “Basic drugs limit of $1,250” reflects older outpatient prescription concepts that are largely associated with pre–Part D benefit structures and not a core Medigap basic benefit in the way the blood coverage is. Therefore, the correct basic benefit is the first 3 pints of blood each year .

The correct answer is D. routine adult dental services. The Affordable Care Act (ACA) prohibits health insurers from placing lifetime or annual dollar limits on coverage for Essential Health Benefits (EHBs) . These essential health benefits include services such as laboratory services, mental health and substance use disorder services, and maternity and newborn care . Because these categories are designated as essential health benefits, insurers are not allowed to impose annual or lifetime dollar caps on them under ACA-compliant health plans.

However, routine adult dental services are not included in the ACA’s list of essential health benefits . While pediatric dental services are included as an essential health benefit category, routine dental coverage for adults is generally offered as an optional or separate benefit. Because it is not classified as an essential health benefit under the ACA, insurers may legally apply dollar limits or other coverage limitations to routine adult dental services depending on the policy design.

Therefore, under ACA regulations applicable to health insurance policies and marketplace plans beginning in 2014, dollar limits are prohibited for essential health benefits but may still apply to non-essential benefits , such as routine adult dental care .

A common disaster clause (often discussed with “simultaneous death” situations) addresses what happens when the insured and the primary beneficiary die in the same accident and it is unclear who died first or they die within a very short period. To prevent the death benefit from being paid to the beneficiary’s estate (and potentially creating delays, disputes, or unintended distribution), the policy provision directs the insurer to handle the claim as though the insured survived the beneficiary . When the insurer proceeds on that assumption, the primary beneficiary is treated as having predeceased the insured, so the death benefit is paid to the contingent beneficiary if one is named. If there is no contingent beneficiary, proceeds generally go according to the policy’s default order (often to the insured’s estate).

This clause helps ensure the insured’s intended “next in line” recipients receive the proceeds and reduces administrative complications when deaths occur together. Therefore, the insurer proceeds as if the insured individual outlived the beneficiary .

The correct answer is Employer . In a key person insurance policy , the business purchases life insurance on the life of an employee, owner, or executive whose services are considered especially valuable to the company. In this arrangement, the business is the policyowner , pays the premiums, and is also named as the beneficiary . If the key person dies, the death benefit is paid to the employer to help offset the financial loss that may result from the death of that important individual.

The purpose of key person insurance is to protect the business against losses such as reduced revenues, replacement and training costs, disruption of operations, loss of credit, or the expense of finding a suitable successor . The policy is not intended primarily to provide personal family protection for the insured employee; that would normally be handled by an individually owned life insurance policy.

The other choices are incorrect because the employee, the insured’s spouse, or a business partner would not ordinarily be the beneficiary unless the policy were structured differently from a standard key person arrangement. In the typical and tested form of key person insurance, the employer is the beneficiary.

When an injury or illness is work-related (“on the job”) , the primary payer for medical expenses and related benefits is workers’ compensation . Workers’ compensation laws are designed to provide benefits for occupational injuries and diseases, including payment for necessary medical treatment and, when applicable, lost-time/indemnity benefits. This priority applies regardless of the employee’s age and is not determined by the size of the employer’s group plan (the “24 employees” detail is often relevant to certain coordination rules such as Medicare secondary payer, but it does not override workers’ compensation responsibility for job-related injuries). The fact that the employee has recovered and returned to work does not change which coverage is primary for the injury event—medical bills connected to that occupational injury are still handled first under workers’ compensation. Medicaid is needs-based coverage and would not be primary when another legally responsible payer exists. Likewise, an individual plan or the employer’s group plan typically coordinates benefits only after workers’ compensation for occupational claims.

The correct answer is A. mutual company . A mutual insurer is an insurance company that is owned by its policyholders rather than by outside stockholders. Because the policyholders are the owners, they may share in the insurer’s favorable operating results through the payment of dividends , when declared by the company. These dividends are not guaranteed and are generally considered a return of excess premium rather than taxable income in the usual licensing context.

The other choices do not match this ownership structure. A stock company is owned by its stockholders , and while it may issue participating policies in some cases, the company itself is not owned by policyholders. A reciprocal exchange is an unincorporated association in which subscribers insure one another through an attorney-in-fact, which is a different legal arrangement. A fraternal society is typically a nonprofit organization providing insurance to members with a common bond and lodge system, not a standard policyholder-owned insurer in the same sense as a mutual company.

For exam purposes, “owned by policyholders” and “may pay annual dividends” directly identify a mutual company .

The correct answer is reaches age 26 . The Affordable Care Act (ACA) introduced a major change in health insurance dependent coverage rules by requiring most health insurance plans that provide dependent coverage to allow children to stay on their parent’s health insurance policy until they reach age 26 . This rule applies to both individual and employer-sponsored health plans .

One important feature of this regulation is that eligibility does not depend on the child’s marital status, student status, financial independence, or residence . This means a young adult may still remain covered under the parent’s plan even if the child is married, living independently, or no longer attending school. The goal of this provision is to reduce the number of uninsured young adults who may otherwise lose coverage after finishing school or aging out of traditional dependent eligibility requirements.

The other options are incorrect because dependent coverage does not automatically end when the child marries, graduates from college, or turns age 19 . The ACA clearly sets the maximum age for dependent coverage at 26 years old , making Option C the correct answer.

Because the owner’s physician, accountant, and insurance consultant are all specifically barred from receiving such referral compensation, the only correct option is D. life settlement broker .

Under New York small group health benefit plan rules, carriers generally must renew coverage for an employer group, but there are specific exceptions where a carrier is permitted to discontinue or refuse renewal . One of the primary permitted reasons is nonpayment of premium —if the employer does not pay required premiums within the policy’s allowed timeframes (including any required grace period), the carrier may terminate or nonrenew coverage because the group is no longer meeting the contractual payment obligation.

The other options do not typically qualify as valid statutory reasons for nonrenewal in the small group market. Merely employing fewer than 15 full-time employees is not a trigger for termination (small group status is based on employer size definitions, but size alone doesn’t justify cancellation). Filing for bankruptcy is not, by itself, a standard guaranteed-renewability exception. Having supplemental coverage with another carrier also does not allow a carrier to cancel, because employers may coordinate coverage arrangements. Therefore, the only option that matches an allowed discontinuance/nonrenewal basis is failure to pay premiums before the end of the grace period .

The correct answer is C. Joint. A joint life insurance policy insures two individuals—most commonly spouses—under one single contract , with the death benefit paid when the first insured person dies . This arrangement is commonly referred to as “first-to-die” coverage . Once the death benefit is paid following the first insured’s death, the policy typically terminates because the contract has fulfilled its purpose. Joint life policies are often used in family financial planning when funds are needed immediately after the first spouse dies to cover expenses such as income replacement, debts, or final expenses.

This differs from survivorship life insurance , also known as second-to-die insurance , where the policy insures two people but the death benefit is paid only after the second insured dies . Survivorship policies are commonly used for estate planning or wealth transfer strategies. The other options are incorrect because dual capacity is not a standard life insurance policy type, and spousal is not the technical term used in life insurance contracts for a first-to-die policy. Therefore, a life insurance policy covering both spouses under one contract with payment at the first death is known as joint life insurance .

The correct answer is A. Immediately. Under accident and health insurance provisions, newborn children must be covered from the moment of birth under an existing health insurance policy that provides dependent coverage. This requirement ensures that medical expenses related to the newborn’s birth and any immediate medical needs are eligible for coverage without delay. The rule is designed to protect infants during the critical period immediately following birth, when medical care is commonly required.

Although coverage begins immediately at birth , most policies and state insurance rules allow the policyholder a limited period—often 30 or 31 days —to formally notify the insurer and add the newborn as a dependent while maintaining continuous coverage from birth. If the policyholder completes the enrollment within that period and pays any additional premium required, coverage remains effective retroactively to the date of birth.

Therefore, the key concept tested in accident and health licensing materials is that a newborn child must be covered immediately upon birth , even though administrative enrollment to formally add the child may occur within a specified time period afterward. This makes “Immediately” the correct answer.

A waiver of premium rider attached to a disability insurance policy allows the insured to stop paying premiums once they become totally disabled , while keeping the policy fully in force. The key principle tested in licensing materials is that the waiver becomes effective based on the date the disability began , not the date the claim was submitted or the date benefits were first paid.

In this case, the insured purchased the policy on January 1 , but the disabling condition began on June 1 . Even though the insured submitted proof of disability on July 1 and began receiving benefits on July 15 , those later dates relate only to the administration and payment of the claim , not to when the waiver eligibility begins.

Under standard disability policy provisions, once the insurer confirms that the insured meets the definition of permanent and total disability , premiums are waived retroactively to the date the disability started (subject to any policy elimination period if applicable). Therefore, the premiums are considered waived beginning June 1 , the date the insured became disabled.

Insurance policies are contracts, but they are also subject to state insurance laws and regulations . When a policy provision conflicts with a state statute, the law controls because statutory requirements set the minimum standards that insurers must follow in that state. Therefore, the policy must be interpreted and administered so it meets at least the minimum statute requirements , even if the printed policy language is more restrictive. In practice, this means a conflicting provision is treated as amended by operation of law to conform to state requirements.

This rule protects consumers by ensuring insurers cannot contract around mandated provisions such as required benefits, mandated grace periods, claim procedures, or required notices. It also supports uniformity and regulatory oversight, since insurers must file forms and comply with state mandates as a condition of doing business.

Option A is not correct because commissioner review does not “fix” conflicts after the fact; the controlling principle is statutory compliance. Option C is incorrect because nonconforming provisions cannot simply stand as written. Option D is incorrect because an insurance contract does not override state law.

Workers’ Compensation is a form of insurance that provides benefits to employees who suffer work-related injuries or occupational illnesses . It is designed as a no-fault system , meaning employees receive benefits regardless of who caused the accident, while employers are generally protected from lawsuits related to workplace injuries. Workers’ Compensation typically provides several types of benefits, including payment of necessary medical expenses , replacement of a portion of lost wages , and coverage for occupational illnesses or diseases that arise from employment conditions. In cases of severe injury or death, additional disability or survivor benefits may also be provided.

However, Workers’ Compensation does not provide benefits for pain and suffering . Compensation for emotional distress or general suffering is usually associated with civil liability lawsuits, not with Workers’ Compensation benefits. The system focuses primarily on economic losses —such as medical costs and lost income—rather than non-economic damages. Because of this trade-off, employees receive quicker access to benefits without needing to prove employer negligence, but they also give up the right to sue the employer for additional damages like pain and suffering.

The correct answer is D. Annually. Life insurance premiums may be paid using several payment modes, including monthly, quarterly, semi-annually, or annually . Although the total annual premium for a policy is based on the insurer’s underwriting calculations, insurers typically apply modal factors when premiums are paid more frequently than once per year. These modal factors slightly increase the cost to cover administrative expenses and the loss of investment income that the insurer would otherwise receive if the premium were paid in one lump sum.

Because of these additional charges, paying premiums monthly, quarterly, or semi-annually usually results in a higher total cost over the course of the year compared to paying the full premium at once. When the premium is paid annually , the policyowner generally avoids these additional modal charges, making it the least expensive payment mode overall .

For this reason, insurance licensing materials and life insurance training commonly explain that while more frequent payment modes may be more convenient for budgeting purposes, annual premium payments provide the lowest total cost for the policyholder over time.

Accident and health (A & H) policies pay benefits only for losses caused by covered injuries or sickness, and they also list specific exclusions —situations for which the insurer will not pay. A very common exclusion across A & H contracts is intentionally self-inflicted injury . The reasoning is that insurance is intended to protect against fortuitous (accidental, unintended) loss, not losses deliberately caused by the insured. Therefore, injuries resulting from intentional self-harm are typically excluded from coverage, and claims arising from such acts are not payable under standard policy language.

The other options do not represent common exclusions. Emergency room coverage is generally a covered service under major medical plans (though subject to copays, deductibles, medical-necessity rules, and network provisions). Coordination of benefits is not an exclusion—it is a claims provision used when an insured has more than one health plan to determine which plan is primary and how benefits are coordinated. Chiropractic services may be covered or limited depending on plan design, but they are not universally excluded in the same way as intentional self-inflicted injury.

The correct answer is Participation or contribution rules have been violated . Under the Health Insurance Portability and Accountability Act (HIPAA), group health insurance plans are generally subject to guaranteed renewability requirements . This means that insurers must typically renew group coverage at the option of the employer or plan sponsor. However, HIPAA provides a few limited exceptions where renewal may legally be denied.

One of these exceptions occurs when the employer or group policyholder fails to comply with the insurer’s participation or employer contribution requirements . Participation rules usually require a minimum percentage of eligible employees to enroll in the plan, while contribution rules require the employer to pay a specified portion of the premium. If the employer fails to meet these requirements or violates the contractual conditions, the insurer may have grounds to deny renewal of the group policy .

The other choices are incorrect. HIPAA does not allow insurers to deny renewal simply because the group had high claims experience , because the group size increased , or because contribution rules were changed . The critical factor is violation of participation or contribution requirements , making Option C the correct answer.

The correct answer is D. Preventive health services. Health benefit plans issued on or after January 1, 2014 became subject to the Affordable Care Act’s essential health benefit and preventive-service requirements for non-grandfathered coverage in the individual and small-group markets. Those rules require coverage for specified preventive services without cost-sharing when provided in accordance with federal guidelines. New York’s post-2014 marketplace coverage materials likewise explain that plans must include the ACA’s required essential health benefits, which include preventive and wellness services.

The other options are not the mandatory general requirement described in this question. Adult eye care and adult dental care are not universally required as core benefits in the same way preventive services are; the ACA’s pediatric services category specifically includes pediatric vision and dental, not broad adult routine vision or dental as mandatory across all such plans. Long-term care services are also not one of the essential health benefits that every post-2014 health benefit plan must provide. Therefore, among the choices given, the service that must be provided is preventive health services