New Hampshire Health Insurance Practice Exam Free - 2026

• A. Each policy may run 12 months and may be renewed twice
• B. No policy may exceed 6 months, and no policy may be issued to a person who had more than 540 days of short-term coverage in the preceding 24 months, so the prospect is ineligible
• C. Each policy may run up to 3 months with no limit on repeat purchases
• D. Short-term policies are prohibited in New Hampshire

Correct answer: B. No policy may exceed 6 months, and no policy may be issued to a person who had more than 540 days of short-term coverage in the preceding 24 months, so the prospect is ineligible

Explanation: RSA 415:5, III allows nonrenewable individual medical, hospital or major medical policies to be issued only for short-term, interim coverage, provides that no such policy may cover a specified term in excess of 6 months, and forbids issuing one to a person who was previously covered under short-term medical policies providing in total more than 540 days of coverage within the preceding 24-month period - so a prospect with 600 days is ineligible. The policies are not prohibited outright, and 12-month renewable or unlimited 3-month terms contradict the statute. See RSA 415:5.

• A. An employer with 2 to 25 employees
• B. An employer with 1 to 100 employees
• C. A business or organization that employed on average one and up to 50 employees on business days during the previous calendar year
• D. An employer with 2 to 50 eligible employees, excluding sole proprietors

Correct answer: C. A business or organization that employed on average one and up to 50 employees on business days during the previous calendar year

Explanation: RSA 420-G:2, XVI(a) defines a small employer as a business or organization which employed on average one and up to 50 employees on business days during the previous calendar year, and subparagraph (b) bases the determination for new employers on the number reasonably expected in the current year. New Hampshire begins the definition at one employee, not two, so D is wrong; 2-25 and 1-100 are definitions used in other states or under older federal thresholds. The 48-employee bakery is a small employer. See RSA 420-G:2.

• A. None; carriers may set any age and tobacco factors they file
• B. Age may vary at most 2 to 1 and tobacco may not be rated at all
• C. Age may vary at most 5 to 1 and tobacco at most 2 to 1, so both are permitted
• D. Age differentials are capped at 3 to 1 for adults and tobacco differentials at 1.5 to 1, so both factors exceed the caps

Correct answer: D. Age differentials are capped at 3 to 1 for adults and tobacco differentials at 1.5 to 1, so both factors exceed the caps

Explanation: RSA 420-G:4, I(d)(1) allows individual and small-group premium rates to vary only by individual versus family coverage, geographic rating area (the whole state is a single area), age with a maximum ratio of 3 to 1 for adults, and tobacco use with a maximum differential of 1.5 to 1; rates must also be guaranteed for a 12-month rating period. A 4-to-1 age spread and a 1.75-to-1 tobacco surcharge both exceed the caps. Option C states the pre-2014 style 5:1 and 2:1 factors, and B invents a 2:1 age cap and a tobacco ban. See RSA 420-G:4.

• A. No; his application falls within the 6-month open enrollment period beginning with the first month of Part B enrollment, and every plan must be offered without regard to age
• B. Yes; New Hampshire open enrollment applies only to applicants age 65 or older
• C. Yes; the open enrollment period is only 3 months from Part B enrollment
• D. No, but the issuer may refuse him all plans except Plan A

Correct answer: A. No; his application falls within the 6-month open enrollment period beginning with the first month of Part B enrollment, and every plan must be offered without regard to age

Explanation: Ins 1905.13(a) prohibits an issuer from denying or conditioning the issuance of any Medicare supplement policy, or discriminating in its pricing, because of health status, claims experience or medical condition when the application is submitted before or during the 6-month period beginning with the first day of the first month in which the individual is enrolled for Medicare Part B, and requires each Medicare supplement policy currently available from the insurer to be made available to all such applicants without regard to age. That age-neutral language means under-65 disabled enrollees like Walter get the full open enrollment, so B and D are wrong, and the period is 6 months, not 3. See N.H. Code Admin. R. Ins 1905.13.

• A. No - dependent coverage ends when the child marries
• B. No - it ends when the child becomes employed
• C. Yes - plans offering dependent coverage must cover adult children to age 26 regardless of marriage, student status, or employment
• D. Yes, but only if he remains a full-time student

Correct answer: C. Yes - plans offering dependent coverage must cover adult children to age 26 regardless of marriage, student status, or employment

Explanation: Plans that offer dependent child coverage must make it available until the child turns 26. Eligibility does not depend on the child's marital status, student status, financial dependence, residence, or employment. The child's own spouse and children, however, are not required to be covered by the parent's plan.

• A. Subsidies that lower the monthly premium for eligible people buying Marketplace coverage
• B. Provisions that let family members combine their deductibles under a single family limit
• C. Subsidies that lower deductibles, copays, and out-of-pocket limits for eligible individuals
• D. Negotiated discounts that reduce what a plan pays hospitals for covered inpatient services

Correct answer: C. Subsidies that lower deductibles, copays, and out-of-pocket limits for eligible individuals

Explanation: Cost-sharing reductions are subsidies that lower out-of-pocket costs (deductibles, copays, coinsurance) for eligible individuals who choose Silver tier Marketplace plans and meet income requirements.

• A. Anyone willing to pay a higher premium
• B. People under age 30, or those with a hardship or affordability exemption
• C. Only people over age 55
• D. Small business owners only

Correct answer: B. People under age 30, or those with a hardship or affordability exemption

Explanation: Catastrophic plans pair low premiums with a very high deductible. They are limited to people under 30 or those granted a hardship or affordability exemption. They cover the essential health benefits after the deductible, plus at least three primary care visits and free in-network preventive care before it - but premium tax credits cannot be applied to them.

• A. To act as the member's main doctor and coordinate care within the network
• B. To provide specialty treatment after the member obtains a referral from the plan
• C. To review submitted claims and decide which charges are medically necessary
• D. To treat the member for any condition outside the network at no added cost

Correct answer: A. To act as the member's main doctor and coordinate care within the network

Explanation: In many HMO arrangements, the primary care physician coordinates routine care and may provide referrals to specialists within the network.

• A. It requires members to select a primary care gatekeeper for referrals
• B. It usually gives members more provider flexibility than an HMO
• C. It generally pays nothing for care from an out-of-network provider
• D. It pays providers a fixed monthly capitation fee per enrolled member

Correct answer: B. It usually gives members more provider flexibility than an HMO

Explanation: A preferred provider organization usually lets members use network providers at better cost sharing while still offering some coverage for out-of-network care.

• A. Preauthorization from the state insurance department
• B. Payment of the annual deductible in full
• C. A referral from the primary care physician
• D. A second opinion from an out-of-network doctor

Correct answer: C. A referral from the primary care physician

Explanation: Gatekeeper HMO models commonly require the primary care physician to coordinate specialist referrals so care stays within the plan's managed network.

• A. The state requires in-network care to be free of any deductible
• B. The provider is paid a capitation fee rather than billing for each visit
• C. The member's premium is reduced each time an in-network provider is used
• D. The provider has agreed to network terms or negotiated rates

Correct answer: D. The provider has agreed to network terms or negotiated rates

Explanation: PPO networks are built around participating providers that agree to plan terms, which can reduce the member's cost sharing compared with out-of-network care.

• A. Managed-care features with some choice to use out-of-network providers
• B. A high-deductible health plan with a tax-advantaged health savings account
• C. Basic hospital coverage with a separate supplemental major medical policy
• D. Group medical coverage with a disability income rider for the employee

Correct answer: A. Managed-care features with some choice to use out-of-network providers

Explanation: A point-of-service plan often blends HMO-style coordination with the option to use providers outside the network, usually at a higher cost.