Valid InsNV_Health02 Test Objectives - New InsNV_Health02 Test Preparation

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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
Accident & Health – General Knowledge	50%	- Types of Policies 1. Medicare supplement policies 2. Disability income Individual disability income policy Business overhead expense policy Business disability buyout policy Group disability income policy Key employee policy 3. Individual and Group Long Term Care Eligibility Levels of care 4. Other policies Dental Vision Cancer Critical illness or specified disease Worksite employer-sponsored Hospital indemnity Short-term medical Accident 5. Group insurance Differences between individual and group contracts General characteristics COBRA 6. 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 7. Accidental death and dismemberment - Field Underwriting Procedures 1. Initial premium payment and receipt 2. Completing the application 3. Policy delivery 4. Explaining policy provisions, riders, exclusions, and ratings 5. Replacement 6. Submitting application and initial premium to company for underwriting 7. Sources of insurability and HIPAA privacy information 8. Contract law Elements of a contract Insurable interest Warranties and representations Unique aspects of the insurance contract - Other Insurance Concepts 1. Cost containment 2. Primary and contingent beneficiaries 3. Tax treatment of premiums and proceeds of insurance contracts 4. Workers Compensation 5. Occupational vs. non-occupational 6. Subrogation 7. Managed care 8. Modes of premium payments 9. Total, partial, recurrent, and residual disability 10. Owner's rights 11. Nonduplication and coordination of benefits 12. Dependent children benefits - Social Insurance 1. Social Security benefits 2. Medicaid 3. Medicare Parts A, B, C, and D - Policy Provisions, Clauses, and Riders 1. Rights of renewability Noncancelable Cancelable Guaranteed renewable 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. 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 4. Riders Impairment and exclusions Guaranteed insurability Future increase option
Nevada Statutes and Codes Common to Life, Health, Property, and Casualty Insurance	20%	- Marketing Practices 1. Affordable Care Act 2. Unfair practices Unfair claims methods and practices and settlement of claims Rebating and inducement Twisting Misrepresentation Fraud Unfair discrimination Defamation 3. Commissions and payment restrictions 4. Required records and record retention 5. Fiduciary responsibilities 6. Silver State Health Insurance Exchange - Insurance Commissioner 1. General powers and duties 2. Examinations 3. Notice and hearings and penalties - Nevada Life and Health Insurance Guaranty Association - Definitions 1. Transacting insurance 2. Authorized and unauthorized 3. Premiums 4. Certificate of authority 5. Insurer 6. Cost-sharing 7. Domestic, foreign, and alien - Licensing 1. Termination of license 2. Renewal and continuing education 3. Persons required to be licensed 4. Suspension, revocation, and refusal of license 5. Name of licensee 6. Obtaining a license
Nevada Statutes and Codes Pertinent to Health Insurance Only	14%	- Medicare 1. Prescription Drug Plan 2. Medicare Advantage Plans 3. Medicare supplement regulation - Coverage for reconstructive surgery - Mandatory policy clauses and provisions 1. Coverage for newborn children 2. Coverage for physical handicap or intellectual disability for dependent children 3. Coverage for preventive healthcare services - Availability of coverage for mental health and treatment of alcohol abuse and drug abuse - Hospice care - Long Term Care

>> Valid InsNV_Health02 Test Objectives <<

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Insurance Licensing NV Accident and Health Sample Questions (Q95-Q100):

NEW QUESTION # 95
Under Nevada law, the definition of " insurer " includes:

A. an indemnitor
B. a security dealer
C. a syndicate
D. a financial planner

Answer: A

Explanation:
Nevada law defines an insurer to include every person engaged as principal and as an indemnitor, surety, or contractor in the business of entering into insurance contracts. Therefore, an indemnitor is specifically included in the statutory definition of insurer.
An indemnitor is a party that agrees to compensate another for specified loss or damage. That obligation is central to insurance: the insurer assumes a defined risk and promises to provide a benefit, payment, service, or indemnity when a covered loss occurs. A surety and a contractor entering insurance agreements can likewise fall within the statutory definition when operating in the insurance business.
A security dealer sells or handles securities and is regulated under securities law rather than by the insurance definition in this question. A financial planner may provide financial advice but is not automatically an insurer. A syndicate may participate in insurance arrangements in certain contexts, but it is not the statutory term specifically identified in the definition.
The exam point is to recognize the broad legal definition of insurer. It encompasses more than a company labeled "insurance company"; it includes persons acting as indemnitors, sureties, or insurance contractors.
Study Guide references/topics: Nevada Insurance Code; definitions; insurer; indemnity; surety; NRS 679A.
100 .

NEW QUESTION # 96
Which of the following is NOT a preventive benefit for adults?

A. Mammograms
B. Skin cancer screening
C. Physical therapy
D. High blood pressure screening

Answer: B

Explanation:
Skin cancer screening is the correct answer because it is not included as a broadly required preventive benefit for adults in the same manner as the other listed services. Preventive-service requirements are tied to specified recommended services and may vary by population, risk status, and recommendation level. A service may be medically useful or covered by a particular policy without being a universally required no-cost preventive benefit.
High blood pressure screening is a standard adult preventive screening. Mammography is a recognized preventive screening benefit for eligible women. Physical therapy can be included in preventive fall- intervention services for certain adults, particularly older adults at risk of falls, when the preventive-service criteria are met. Thus, the question is testing the distinction between services commonly covered in some circumstances and services specifically identified as preventive benefits.
Skin examinations or skin cancer evaluations may be medically necessary when a lesion, symptom, prior diagnosis, or risk factor is present. In that circumstance, the service may be classified as diagnostic rather than preventive and can be subject to policy terms and cost sharing.
For examination purposes, remember that preventive-benefit questions focus on the mandated screening list and preventive-care criteria, not merely on whether a service can be medically valuable.
Study Guide references/topics: preventive care; adult screenings; in-network preventive benefits; adult preventive-care benefits .

NEW QUESTION # 97
Under a life insurance policy with a revocable beneficiary designation, who normally has the authority to change the beneficiary?

A. The insurer
B. The beneficiary
C. The insured, regardless of ownership
D. The policyowner

Answer: D

Explanation:
The policyowner normally holds the contractual rights known as incidents of ownership. When the beneficiary designation is revocable, the policyowner may generally change the beneficiary without obtaining that beneficiary's consent, provided the policy is in force and no assignment or court order restricts the right.
The owner may also ordinarily exercise other ownership rights, such as selecting premium-payment modes, assigning the policy, taking a policy loan when available, surrendering the policy for cash value, and electing settlement options.
The insured and the owner can be the same person, but they do not have to be. The insured is the person whose life is covered and whose death triggers payment of the death benefit. A beneficiary is the person or entity designated to receive policy proceeds. Those roles must be kept separate on examination questions. A revocable beneficiary has only an expectancy until the insured dies; by contrast, an irrevocable beneficiary usually has a vested interest that limits the owner's ability to change the designation or exercise certain policy rights without consent.
Correctly identifying the owner is essential because ownership determines control of the policy during the insured's lifetime.
References/topics from the Study Guide: Policyowners' Rights; Beneficiary Designations; Revocable and Irrevocable Beneficiaries; Assignments.

NEW QUESTION # 98
Which statement is true of a variable life insurance policy?

A. The cash value may fluctuate with separate-account investment performance.
B. The policyowner bears no investment risk.
C. The policy is always a temporary term policy.
D. The cash value is held only in the insurer's general account.

Answer: A

Explanation:
Variable life insurance is permanent life insurance with cash values invested in separate-account investment options. Because the value of those investments can rise or fall, the policyowner bears the investment risk.
The policy's cash value may fluctuate based on market performance, and the death benefit may vary above a guaranteed minimum amount, subject to policy provisions. The insurer does not guarantee the investment performance of the separate account.
Variable life insurance differs from whole life, where the insurer's general account supports guaranteed cash values and fixed premiums. It also differs from universal life, which emphasizes flexible premiums and adjustable death-benefit structures. Variable universal life combines flexible-premium features with separate- account investment options. All such products must be described accurately because the potential for growth is accompanied by potential loss.
Because variable life is a security as well as an insurance product, a producer generally needs appropriate securities registration and authorization in addition to life insurance licensing. Suitability is especially important. The product may be appropriate only for a consumer with a long time horizon, tolerance for market volatility, and a need for permanent life insurance. It should not be sold as a guaranteed investment or as equivalent to a fixed life policy.
References/topics from the Study Guide: Variable Life Insurance; Separate Accounts; General Accounts; Securities Registration; Investment Risk; Suitability.

NEW QUESTION # 99
Which person is generally eligible to establish and contribute to a health savings account (HSA)?

A. A person enrolled in Medicare Part A
B. A person claimed as another taxpayer's dependent
C. A person covered by a qualified high-deductible health plan and meeting other eligibility requirements
D. A person enrolled in any health plan with no deductible

Answer: C

Explanation:
An HSA is generally available to an eligible individual who is covered by a qualified high-deductible health plan, commonly called an HDHP, and who meets the other federal eligibility requirements. The account is owned by the individual, not the employer or insurer. Contributions may be made by the individual, an employer, or another person, subject to annual contribution limits. Qualified distributions used for eligible medical expenses are generally tax advantaged under federal rules.
Eligibility is not based solely on having a high deductible. The health plan must meet the federal HDHP requirements for the applicable year. In addition, an individual generally cannot be enrolled in Medicare, cannot be claimed as another person's tax dependent, and cannot have disqualifying other health coverage.
Because federal limits and requirements can change, the producer should not provide individualized tax advice and should refer the consumer to current IRS guidance or a qualified tax professional.
An HSA differs from a flexible spending arrangement because unused HSA funds generally remain with the account owner and may carry forward. It also differs from health insurance itself; the HSA is a tax- advantaged account used alongside an eligible health plan.
References/topics from the Study Guide: Health Savings Accounts; High-Deductible Health Plans; Consumer- Directed Health Plans; Tax-Advantaged Medical Accounts.

NEW QUESTION # 100
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