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Insurance Licensing InsNV_Health02 Exam Syllabus Topics:

SectionWeightObjectives
Topic 1: Nevada Statutes, Rules and Regulations~32%- Nevada Health-Specific Regulations
  • 1. Replacement and Free-Look Provisions
  • 2. Advertising and Disclosure Rules
  • 3. Group and Credit Health Rules
- General State Insurance Regulations
  • 1. Marketing Practices and Unfair Trade
  • 2. Insurance Guaranty Associations
  • 3. Insurance Commissioner Authority
  • 4. Agent Licensing Requirements
  • 5. Definitions and General Provisions
Topic 2: Accident and Health — General Knowledge~68%- Social Insurance / Government Plans
  • 1. Social Security Disability Benefits
  • 2. Medicaid
  • 3. Medicare (Parts A, B, C, D)
- Types of Health Insurance Policies
  • 1. Medicare Supplement Policies
  • 2. Long-Term Care (LTC) Insurance
  • 3. Medical Expense / Major Medical Insurance
  • 4. Disability Income Insurance
  • 5. Group Health Insurance
  • 6. Accidental Death & Dismemberment
  • 7. Limited Benefit Plans
- Insurance Concepts and Underwriting
  • 1. Application and Underwriting
  • 2. Premiums and Renewal
  • 3. Insurance Basics and Risk
- Policy Provisions, Clauses & Riders
  • 1. Other Provisions and Clauses
  • 2. Optional Provisions
  • 3. Mandatory Uniform Provisions
  • 4. Common Riders

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Insurance Licensing NV Accident and Health Sample Questions (Q106-Q111):

NEW QUESTION # 106
According to Nevada law, an authorized insurer is BEST defined as:

Answer: C

Explanation:
An authorized insurer is an insurer that holds a certificate of authority issued by the Nevada Insurance Commissioner and remains authorized to transact insurance in the state. The certificate of authority is the formal approval allowing the insurer to conduct the kinds of insurance business for which it has been approved.
Having sufficient assets may be one consideration in an insurer's application and ongoing financial regulation, but assets alone do not make an insurer authorized. The National Association of Insurance Commissioners develops model laws, standards, and regulatory resources; it does not issue Nevada certificates of authority. The Governor of Nevada likewise does not issue insurance certificates of authority.
This distinction is central to Nevada insurance regulation. Authorized, or admitted, insurers are subject to Nevada's ongoing solvency oversight, market-conduct regulation, rate and form requirements where applicable, examinations, and other statutory obligations. Nonadmitted insurers may be used only through the surplus-lines process or another applicable statutory exception.
A producer must understand whether an insurer is authorized before placing ordinary insurance business.
Selling or placing insurance with an unauthorized insurer outside a lawful exception can create serious regulatory consequences.
Study Guide references/topics: authorized insurers; admitted insurers; certificates of authority; insurer regulation; NRS 680A.020 .


NEW QUESTION # 107
A doctor who is receiving Disability Income benefits is not able to return to work full-time but continues practicing on a part-time basis. Which of the following policy features would allow the doctor to continue receiving benefits?

Answer: D

Explanation:
The correct answer is A. A residual benefit clause permits an insured who has returned to work on a limited basis, but still suffers a loss of income because of disability, to receive partial disability benefits. The doctor is able to practice part-time but cannot resume full-time work, so the disability continues to cause an earnings loss. Residual benefits are intended to encourage rehabilitation and return to productive work without forcing the insured to lose all benefits immediately. The benefit amount is usually tied to the percentage of income lost compared with pre-disability earnings, subject to policy requirements. A contingent benefit clause and concurrent benefit clause are not the standard disability-income provisions that address partial return to work.
A guaranteed insurability rider permits future increases in coverage without proof of insurability; it does not pay benefits for a continuing partial disability. Residual disability should be distinguished from total disability, which generally requires inability to perform the duties defined in the policy. Study Guide References/Topics: Policy Provisions, Clauses, and Riders; Disability Income Insurance; Residual Disability Benefits.


NEW QUESTION # 108
A policyowner names two children as beneficiaries "per stirpes." If one child dies before the insured but leaves children, how are that deceased child's share and the surviving child's share handled?

Answer: D

Explanation:
A per stirpes beneficiary designation means "by the branch" or "by the bloodline." If a named beneficiary dies before the insured, that beneficiary's descendants take the deceased beneficiary's share. In this question, the deceased child's children receive the share that would have gone to their parent, while the surviving child receives that child's own share. This preserves each family branch's intended portion of the life insurance proceeds.
A per capita designation works differently. Under a per capita arrangement, surviving members of a named class generally share equally, and a deceased beneficiary's descendants do not automatically take the deceased beneficiary's share unless the designation or policy language provides otherwise. The precise result always depends on the policy designation, applicable law, and any contingent- beneficiary provisions.
Beneficiary designations should be reviewed after divorce, marriage, birth, death, adoption, or other major changes. A producer should not provide legal advice about estate planning, but should encourage the policyowner to obtain professional legal guidance when the designation involves trusts, minors, estates, complex family arrangements, or special-needs planning.
The test point is straightforward: per stirpes preserves the deceased beneficiary's branch; per capita distributes among the surviving members of the class.
References/topics from the Study Guide: Beneficiary Designations; Per Stirpes; Per Capita; Primary and Contingent Beneficiaries; Estate Planning Basics.


NEW QUESTION # 109
J and K are married and have several children. J is the primary beneficiary on K ' s Accidental Death and Dismemberment (AD & D) policy, and K ' s sibling, L, is the contingent beneficiary. J, K, and L are involved in a train accident, and K and L are killed instantly. The Accidental Death benefits will be paid to:

Answer: D

Explanation:
The correct answer is D, J only. A primary beneficiary has the first right to receive policy proceeds. J is named as K's primary beneficiary and survives the accident. Therefore, the AD & D benefit is paid directly to
J. The contingent beneficiary, L, would receive the proceeds only if the primary beneficiary had died before K or could not receive the benefit under the policy terms. Because J remains alive, L's death does not change the payment outcome. The proceeds do not pass to K's estate because a living named primary beneficiary exists.
They also do not pass to L's estate, because L never became entitled to the benefit; the contingency never occurred. Beneficiary designations control over general assumptions about family relationships or estates. The insured should keep beneficiary designations current after changes in family status, death, divorce, or estate- planning decisions. A simultaneous-death provision can alter outcomes if the beneficiary and insured die in the same event and survivorship cannot be determined, but the facts here identify K and L as deceased while J survives. Study Guide References/Topics: Group Health Insurance; Accidental Death and Dismemberment; Beneficiary Designations.


NEW QUESTION # 110
Which of the following is permitted by a licensee?

Answer: C

Explanation:
A licensee may give a client a nominal gift, such as an ordinary Christmas gift, so long as the gift complies with Nevada's statutory limits and is not used as an unlawful inducement. Nevada permits producers and insurers to provide certain gifts, goods, gift certificates, meals, event tickets, and similar items to a policyholder or prospective policyholder up to an aggregate value of $100 in a calendar year.
Rebating is prohibited. A producer may not reduce the premium by giving back all or part of a commission, nor may the producer return a commission to induce the client to buy, retain, or renew insurance. The prohibition protects consumers and preserves fair competition by requiring premiums and policy benefits to be applied consistently.
Altering an application to obtain a lower premium is also prohibited. Application answers must accurately reflect the applicant's information. Knowingly changing material information can constitute misrepresentation, fraud, and grounds for producer discipline.
The exam distinction is straightforward: a modest, permitted gift is lawful; a rebate, commission return, or falsification of application information is not.
Study Guide references/topics: rebating; inducements; producer ethics; application accuracy; NRS 686A.110 .


NEW QUESTION # 111
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