Nebraska Health Insurance Practice Exam Free - 2026

• A. 18 months, at 102 percent of the group premium
• B. 6 months, at 100 percent of the group premium
• C. 12 months, at 102 percent of the group premium
• D. 6 months, at 102 percent of the group premium

Correct answer: D. 6 months, at 102 percent of the group premium

Explanation: Neb. Rev. Stat. § 44-1640 requires a non-COBRA employer group policy to let an involuntarily terminated employee continue coverage on a monthly basis until the earliest of several dates, including the end of six months after coverage would otherwise end, and caps the monthly premium at one hundred two percent of the group premium, paid by the employee. Eighteen months is the federal COBRA period, twelve months is not the Nebraska limit (one year applies to surviving spouses under § 44-1643), and one hundred percent understates the permitted charge. See Neb. Rev. Stat. § 44-1640.

• A. Notice within 10 days; election and first premium within 10 days of receipt
• B. Notice within 30 days; election within 60 days of receipt
• C. Notice within 15 days; election within 30 days of receipt
• D. Notice within 60 days; election within 60 days of receipt

Correct answer: A. Notice within 10 days; election and first premium within 10 days of receipt

Explanation: Neb. Rev. Stat. § 44-1641 requires the employer, not later than ten days after termination, to send the terminated employee a notice by certified mail, return receipt requested, stating the continuation right, the monthly premium, and how to elect; § 44-1642 then requires the employee to send the election form and first monthly premium to the insurer or HMO by certified mail within ten days after receiving the notice. Thirty and sixty days reflect federal COBRA timing, and fifteen days is the acknowledgment period in the claims settlement rules, not the continuation notice period. See Neb. Rev. Stat. § 44-1641.

• A. $300,000
• B. $500,000
• C. $100,000
• D. $250,000

Correct answer: B. $500,000

Explanation: Neb. Rev. Stat. § 44-2703(3)(b)(i)(B) sets the association's health insurance limits per life at $500,000 for health benefit plans, $300,000 for disability income or long-term care insurance, and $100,000 for other health coverages, and § 44-2703(3)(b)(iii)(A) raises the usual $300,000 per-life aggregate to $500,000 for health benefit plans. Three hundred thousand dollars is the disability and long-term care limit, one hundred thousand dollars is the limit for other health coverages, and two hundred fifty thousand dollars is the annuity limit. See Neb. Rev. Stat. § 44-2703.

• A. At least 1 and no more than 50
• B. At least 2 and no more than 100
• C. At least 2 and no more than 50
• D. At least 1 and no more than 100

Correct answer: C. At least 2 and no more than 50

Explanation: Neb. Rev. Stat. § 44-5253 defines a small employer as a person, firm, or entity actively engaged in business that, on at least fifty percent of its working days during the preceding calendar quarter, employed at least two and no more than fifty eligible employees, the majority of whom were employed within Nebraska, with affiliated companies counted as one employer. One-employee groups and groups up to one hundred are not within the Nebraska definition. See Neb. Rev. Stat. § 44-5253.

• A. An ethical obligation to recommend coverage that suits the client's needs
• B. A fiduciary duty to hold the client's premium payments in a separate trust account
• C. A legal obligation to recommend the policy that produces the highest commission
• D. An obligation to recommend the plan with the broadest benefits regardless of cost

Correct answer: A. An ethical obligation to recommend coverage that suits the client's needs

Explanation: A producer is expected to act honestly and recommend coverage that fits the client's needs, rather than steering the sale toward the highest commission or the most expensive product. In agency law the producer legally represents the insurer, and a binding legal best-interest standard applies only in specific contexts such as annuity suitability rules. The separate term fiduciary responsibility usually refers to holding premium funds in trust without commingling them.

• A. A schedule of usual and customary charges for covered services
• B. A list of network providers a member may use for care
• C. A list of prescription drugs covered by a health plan
• D. A list of pre-existing conditions excluded from a health plan

Correct answer: C. A list of prescription drugs covered by a health plan

Explanation: A formulary is a list of prescription drugs covered by a health insurance plan. Drugs are often organized into tiers, with different cost-sharing amounts for each tier.

• A. Requiring plan approval before a specialty drug is dispensed
• B. Limiting the quantity of a drug a member may fill in a given period
• C. Charging progressively higher copayments as drugs move up formulary tiers
• D. Requiring trial of lower-cost drugs before more expensive options

Correct answer: D. Requiring trial of lower-cost drugs before more expensive options

Explanation: Step therapy requires patients to try one or more lower-cost medications (typically generics) before the plan will cover a more expensive brand-name drug for a condition.

• A. Coverage for assistance with daily living activities when unable to care for oneself
• B. Coverage that replaces lost income when a disability keeps the insured from working
• C. Coverage for extended inpatient hospital stays beyond major medical benefit limits
• D. Coverage that pays the gaps left by Medicare for physician and hospital deductibles

Correct answer: A. Coverage for assistance with daily living activities when unable to care for oneself

Explanation: Long-term care insurance covers services needed when a person cannot perform activities of daily living (like bathing, dressing, eating) due to chronic illness, disability, or cognitive impairment.

• A. Household tasks such as shopping and managing money and medications
• B. Basic self-care tasks used to measure need for long-term care
• C. Skilled nursing services ordered by a physician for a chronic condition
• D. Cognitive tests used to diagnose dementia before benefits are paid

Correct answer: B. Basic self-care tasks used to measure need for long-term care

Explanation: Activities of daily living (ADLs) are basic self-care tasks including bathing, dressing, eating, toileting, transferring (moving), and continence. Inability to perform ADLs often triggers long-term care benefits.

• A. The waiting period that must pass before benefits begin
• B. The event that causes premiums to be waived during a claim
• C. The criteria that must be met before benefits are paid
• D. The maximum number of days for which benefits will be paid

Correct answer: C. The criteria that must be met before benefits are paid

Explanation: A benefit trigger is the condition that must be met before long-term care insurance benefits begin. Common triggers include inability to perform a certain number of ADLs or cognitive impairment.

• A. Requiring every health plan to offer mental health benefits as a covered service
• B. Requiring equal premium rates for members with and without a mental health diagnosis
• C. Requiring mental health screening before a policy is issued to an applicant
• D. Requiring equal coverage for mental health as for medical/surgical conditions

Correct answer: D. Requiring equal coverage for mental health as for medical/surgical conditions

Explanation: Mental health parity means that when a plan does cover mental health and substance use disorder benefits, the financial requirements and treatment limitations applied to them may be no more restrictive than those applied to medical and surgical benefits. Parity does not by itself require a plan to offer mental health coverage; that obligation comes from the essential health benefits rules for individual and small group plans.

• A. Setting premiums based on the entire community rather than individual health status
• B. Setting premiums based on each applicant's individual medical history
• C. Insurance for community organizations
• D. Setting premiums based on a group's actual claims history

Correct answer: A. Setting premiums based on the entire community rather than individual health status

Explanation: Community rating is a method of setting premiums where everyone in a geographic area pays the same base rate, regardless of individual health status. The ACA requires modified community rating.