Pass Guaranteed Quiz 2026 InsNV_Health02: NV Accident and Health Authoritative Exam

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Insurance Licensing InsNV_Health02 Exam Syllabus Topics:

Section	Weight	Objectives
Nevada Statutes and Codes Common to Life and Health Insurance Only	4%	- Credit life and health insurance - Group life and health insurance 1. Eligible groups 2. Required provisions - Advertising
Nevada Statutes and Codes Common to Life, Health, Property, and Casualty Insurance	20%	- Marketing Practices 1. Silver State Health Insurance Exchange 2. Affordable Care Act 3. Commissions and payment restrictions 4. Unfair practices Unfair claims methods and practices and settlement of claims Rebating and inducement Twisting Misrepresentation Fraud Unfair discrimination Defamation 5. Fiduciary responsibilities 6. Required records and record retention - Definitions 1. Certificate of authority 2. Transacting insurance 3. Premiums 4. Authorized and unauthorized 5. Cost-sharing 6. Insurer 7. Domestic, foreign, and alien - Insurance Commissioner 1. Notice and hearings and penalties 2. Examinations 3. General powers and duties - Nevada Life and Health Insurance Guaranty Association - Licensing 1. Renewal and continuing education 2. Obtaining a license 3. Suspension, revocation, and refusal of license 4. Termination of license 5. Persons required to be licensed 6. Name of licensee
Nevada Statutes and Codes Pertinent to Health Insurance Only	14%	- Medicare 1. Prescription Drug Plan 2. Medicare supplement regulation 3. Medicare Advantage Plans - Coverage for reconstructive surgery - Mandatory policy clauses and provisions 1. Coverage for newborn children 2. Coverage for preventive healthcare services 3. Coverage for physical handicap or intellectual disability for dependent children - Hospice care - Availability of coverage for mental health and treatment of alcohol abuse and drug abuse - Long Term Care
Accident & Health – General Knowledge	50%	- Field Underwriting Procedures 1. Submitting application and initial premium to company for underwriting 2. Sources of insurability and HIPAA privacy information 3. Explaining policy provisions, riders, exclusions, and ratings 4. Policy delivery 5. Initial premium payment and receipt 6. Contract law Elements of a contract Insurable interest Warranties and representations Unique aspects of the insurance contract 7. Completing the application 8. Replacement - Social Insurance 1. Social Security benefits 2. Medicare Parts A, B, C, and D 3. Medicaid - Types of Policies 1. Accidental death and dismemberment 2. Disability income Individual disability income policy Business overhead expense policy Business disability buyout policy Group disability income policy Key employee policy 3. Medicare supplement policies 4. Other policies Dental Vision Cancer Critical illness or specified disease Worksite employer-sponsored Hospital indemnity Short-term medical Accident 5. Medical expense insurance Basic hospital, medical, and surgical policies Major medical policies Health Maintenance Organizations Preferred Provider Organizations Point of Service plans Flexible Spending Accounts High Deductible Health Plans and Health Savings Accounts Health Reimbursement Accounts 6. Group insurance Differences between individual and group contracts General characteristics COBRA 7. Individual and Group Long Term Care Eligibility Levels of care - Policy Provisions, Clauses, and Riders 1. Riders Impairment and exclusions Guaranteed insurability Future increase option 2. Mandatory and optional provisions Entire contract Time limit on certain defenses Grace period Reinstatement Notice of claim Claim forms Proof of loss Time of payment of claims Payment of claims Physical examination and autopsy Legal actions Change of beneficiary Misstatement of age or gender Change of occupation Illegal occupation Relation of earnings to insurance 3. Rights of renewability Noncancelable Cancelable Guaranteed renewable 4. Other provisions and clauses Insuring clause Free look Consideration clause Probationary period Elimination period Waiver of premium Exclusions and limitations Preexisting conditions Coinsurance Deductibles Eligible expenses Copayments Pre-authorizations and prior approval requirements Usual, reasonable, and customary charges Lifetime, annual, or per cause maximum benefit limits - Other Insurance Concepts 1. Managed care 2. Nonduplication and coordination of benefits 3. Cost containment 4. Primary and contingent beneficiaries 5. Subrogation 6. Dependent children benefits 7. Occupational vs. non-occupational 8. Total, partial, recurrent, and residual disability 9. Workers Compensation 10. Modes of premium payments 11. Owner's rights 12. Tax treatment of premiums and proceeds of insurance contracts

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Insurance Licensing NV Accident and Health Sample Questions (Q37-Q42):

NEW QUESTION # 37
Which feature is most characteristic of universal life insurance?

A. Coverage that can never build cash value
B. Flexible premiums and adjustable death-benefit options, subject to policy requirements
C. Investment risk borne entirely by the insurer in a separate account
D. A fixed premium and fixed death benefit with no flexibility

Answer: B

Explanation:
Universal life insurance is a flexible-premium permanent life insurance policy. It generally provides a cash- value account, interest crediting, mortality charges, expense charges, and flexible premium-payment options within policy limits. The owner may often adjust the amount and timing of premiums and may have death- benefit options, subject to minimum funding requirements, underwriting rules for increases, and the policy's terms. The flexibility does not mean the owner can stop paying indefinitely without consequence. If cash value is insufficient to cover monthly deductions and charges, the policy can lapse.
Universal life differs from traditional whole life, which typically has fixed premiums, a guaranteed cash-value schedule, and a fixed death benefit. It also differs from variable life, in which cash value and death benefit are linked to separate-account investments and market performance. Universal life typically uses the insurer's general account for interest crediting, although variable universal life is a separate product combining flexibility with separate-account investment risk.
A producer must explain that illustrated values are not guaranteed unless identified as such. Policyowners should receive in-force illustrations and review funding adequacy periodically, particularly after taking loans, withdrawals, or reducing premium payments.
References/topics from the Study Guide: Universal Life Insurance; Flexible Premiums; Adjustable Death Benefit; Cash Value; Policy Lapse Risk.

NEW QUESTION # 38
When a nonqualified annuity is surrendered for more than the owner's investment in the contract, how is the gain generally treated for federal income-tax purposes?

A. As a tax-free return of principal only
B. As a deductible business loss
C. As a long-term capital gain in all cases
D. As ordinary income

Answer: D

Explanation:
Gain from a nonqualified annuity is generally taxed as ordinary income when distributed. The owner's investment in the contract, often called the cost basis, is not taxed again because it was paid with after-tax dollars. However, the growth above that basis is tax-deferred only while it remains inside the annuity. When the owner surrenders the contract or receives a taxable distribution, the gain is subject to ordinary-income treatment rather than the preferential capital-gains treatment that may apply to certain investments.
A nonqualified annuity is funded with after-tax money and is not held inside a qualified retirement arrangement such as an IRA or employer plan. The contract's tax deferral can be valuable for long-term planning, but it does not mean that every distribution is tax free. In addition, distributions before age 59½ may be subject to an additional federal tax penalty unless an exception applies. A full surrender may also trigger a surrender charge under the contract if it occurs during the surrender-charge period.
The producer should never present an annuity as tax avoidance. The accurate explanation is tax deferral, possible ordinary-income taxation of gain upon distribution, potential penalties for early distributions, and the importance of consulting a qualified tax adviser for individual circumstances.
References/topics from the Study Guide: Annuity Taxation; Nonqualified Annuities; Cost Basis; Tax Deferral; Surrender Charges.

NEW QUESTION # 39
Group coverage for a handicapped dependent child may be continued if the primary insured submits the required proof to the insurance company within what MAXIMUM period of time after the child reaches the limiting age?

A. 45 days
B. 30 days
C. 31 days
D. 15 days

Answer: C

NEW QUESTION # 40
If coverage has stayed in force with the same insurance company, what is the maximum number of years for which reconstructive surgery (mastectomy) benefits must be provided?

A. 0
B. 1
C. 2
D. 3

Answer: A

Explanation:
If reconstructive surgery is begun within three years after a mastectomy, the amount of benefits for that surgery must equal the amount provided by the policy at the time of the mastectomy. Therefore, the tested maximum period is three years.
Nevada requires a policy that covers mastectomy to provide commensurate coverage for reconstruction of the breast on which the mastectomy was performed, surgery and reconstruction of the other breast to create symmetry, prostheses, and treatment of physical complications of all stages of mastectomy, including lymphedema. The attending physician and patient determine the appropriate care.
The three-year rule protects an insured from losing the original level of reconstruction benefits merely because reconstruction is delayed. If surgery begins more than three years after the mastectomy, benefits are governed by the policy terms, conditions, and exclusions in effect at the time reconstructive surgery begins.
This question does not ask how long all reconstruction coverage disappears. It tests the period during which the policy must preserve the benefit amount available at the time of mastectomy.
Study Guide references/topics: mastectomy coverage; reconstructive surgery; breast reconstruction; mandated health benefits; NRS 689B.0375 .

NEW QUESTION # 41
The maximum cost share for preventive screening from an in-network provider is:

A. 30%
B. 0%
C. 20%
D. 10%

Answer: B

Explanation:
The maximum cost share for a covered preventive screening received from an in-network provider is 0%. In practical terms, the insured generally pays no deductible, copayment, or coinsurance for qualifying preventive services delivered in-network. This rule is intended to encourage early detection of illness and promote preventive care before conditions become more serious and costly.
Examples of qualifying preventive care can include certain screenings, immunizations, counseling, and wellness services. The precise covered service and frequency may depend on age, sex, medical circumstances, and the applicable preventive-service recommendations. The in-network condition is important because services received outside the plan's network may be subject to different cost-sharing rules, except where other law or plan provisions apply.
The choices of 10%, 20%, and 30% reflect ordinary coinsurance levels that may apply to nonpreventive treatment or to services that do not qualify for first-dollar preventive coverage. They do not apply to an eligible preventive screening under the in-network preventive-care rule.
Always distinguish preventive screening from diagnostic care. A screening is generally performed when no symptom or suspected condition is being evaluated; a diagnostic service may generate cost sharing depending on the circumstances and plan terms.
Study Guide references/topics: preventive services; in-network providers; deductibles; copayments; coinsurance; HealthCare.gov preventive-care guidance .

NEW QUESTION # 42
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