100% Pass 2026 Insurance Licensing First-grade InsNV_Health02: NV Accident and Health Latest Exam Simulator

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Insurance Licensing InsNV_Health02 Exam Syllabus Topics:

SectionWeightObjectives
Nevada Statutes and Codes Common to Life, Health, Property, and Casualty Insurance20%- Licensing
  • 1. Renewal and continuing education
    • 2. Suspension, revocation, and refusal of license
      • 3. Termination of license
        • 4. Name of licensee
          • 5. Obtaining a license
            • 6. Persons required to be licensed
              - Marketing Practices
              • 1. Commissions and payment restrictions
                • 2. Silver State Health Insurance Exchange
                  • 3. Fiduciary responsibilities
                    • 4. Unfair practices
                      • Unfair claims methods and practices and settlement of claims
                      • Rebating and inducement
                      • Twisting
                      • Misrepresentation
                      • Fraud
                      • Unfair discrimination
                      • Defamation
                    • 5. Affordable Care Act
                      • 6. Required records and record retention
                        - Nevada Life and Health Insurance Guaranty Association
                        - Insurance Commissioner
                        • 1. General powers and duties
                          • 2. Notice and hearings and penalties
                            • 3. Examinations
                              - Definitions
                              • 1. Authorized and unauthorized
                                • 2. Certificate of authority
                                  • 3. Transacting insurance
                                    • 4. Cost-sharing
                                      • 5. Premiums
                                        • 6. Insurer
                                          • 7. Domestic, foreign, and alien
                                            Accident & Health – General Knowledge50%- Field Underwriting Procedures
                                            • 1. Policy delivery
                                              • 2. Contract law
                                                • Elements of a contract
                                                • Insurable interest
                                                • Warranties and representations
                                                • Unique aspects of the insurance contract
                                              • 3. Submitting application and initial premium to company for underwriting
                                                • 4. Completing the application
                                                  • 5. Replacement
                                                    • 6. Initial premium payment and receipt
                                                      • 7. Sources of insurability and HIPAA privacy information
                                                        • 8. Explaining policy provisions, riders, exclusions, and ratings
                                                          - Other Insurance Concepts
                                                          • 1. Tax treatment of premiums and proceeds of insurance contracts
                                                            • 2. Total, partial, recurrent, and residual disability
                                                              • 3. Dependent children benefits
                                                                • 4. Managed care
                                                                  • 5. Workers Compensation
                                                                    • 6. Modes of premium payments
                                                                      • 7. Occupational vs. non-occupational
                                                                        • 8. Primary and contingent beneficiaries
                                                                          • 9. Owner's rights
                                                                            • 10. Subrogation
                                                                              • 11. Cost containment
                                                                                • 12. Nonduplication and coordination of benefits
                                                                                  - Social Insurance
                                                                                  • 1. Medicare Parts A, B, C, and D
                                                                                    • 2. Social Security benefits
                                                                                      • 3. Medicaid
                                                                                        - Types of Policies
                                                                                        • 1. Medicare supplement policies
                                                                                          • 2. Other policies
                                                                                            • Dental
                                                                                            • Vision
                                                                                            • Cancer
                                                                                            • Critical illness or specified disease
                                                                                            • Worksite employer-sponsored
                                                                                            • Hospital indemnity
                                                                                            • Short-term medical
                                                                                            • Accident
                                                                                          • 3. Accidental death and dismemberment
                                                                                            • 4. 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
                                                                                            • 5. Individual and Group Long Term Care
                                                                                              • Eligibility
                                                                                              • Levels of care
                                                                                            • 6. Disability income
                                                                                              • Individual disability income policy
                                                                                              • Business overhead expense policy
                                                                                              • Business disability buyout policy
                                                                                              • Group disability income policy
                                                                                              • Key employee policy
                                                                                            • 7. Group insurance
                                                                                              • Differences between individual and group contracts
                                                                                              • General characteristics
                                                                                              • COBRA
                                                                                            - 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 and Health Insurance Only4%- Advertising
                                                                                            - Group life and health insurance
                                                                                            • 1. Required provisions
                                                                                              • 2. Eligible groups
                                                                                                - Credit life and health insurance
                                                                                                Nevada Statutes and Codes Pertinent to Health Insurance Only14%- Availability of coverage for mental health and treatment of alcohol abuse and drug abuse
                                                                                                - Mandatory policy clauses and provisions
                                                                                                • 1. Coverage for preventive healthcare services
                                                                                                  • 2. Coverage for physical handicap or intellectual disability for dependent children
                                                                                                    • 3. Coverage for newborn children
                                                                                                      - Long Term Care
                                                                                                      - Hospice care
                                                                                                      - Coverage for reconstructive surgery
                                                                                                      - Medicare
                                                                                                      • 1. Medicare supplement regulation
                                                                                                        • 2. Medicare Advantage Plans
                                                                                                          • 3. Prescription Drug Plan

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                                                                                                            InsNV_Health02 Exam Blueprint & Latest InsNV_Health02 Cram Materials

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                                                                                                            Insurance Licensing NV Accident and Health Sample Questions (Q50-Q55):

                                                                                                            NEW QUESTION # 50
                                                                                                            According to Nevada law, an authorized insurer is BEST defined as:

                                                                                                            Answer: B

                                                                                                            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 # 51
                                                                                                            Which person is the measuring life whose survival determines the timing and duration of annuity payments?

                                                                                                            Answer: A

                                                                                                            Explanation:
                                                                                                            The annuitant is the person whose life expectancy is used to determine the amount, timing, or duration of annuity payments. The annuitant is not necessarily the contract owner or the beneficiary. In many personally owned annuities, one person may occupy more than one role, but examination questions frequently separate them. The owner controls contractual rights, including premium payments, beneficiary changes, withdrawals when permitted, and surrender decisions. The annuitant is the measuring life. The beneficiary receives remaining contract value or death proceeds if the owner or annuitant dies, depending on the contract design.
                                                                                                            During the accumulation period, the owner pays premiums or transfers funds into the annuity. During the annuitization period, the accumulated value is converted into a stream of income payments. The annuitant's age and selected payout option influence the payment calculation. A life-income option normally provides larger periodic payments for an older annuitant because the expected payment period is shorter.
                                                                                                            Do not confuse the annuitant with the insured under life insurance. Life insurance is designed primarily to create a death benefit upon the insured's death. An annuity is designed primarily to provide income during life, although death-benefit provisions may apply before annuitization.
                                                                                                            References/topics from the Study Guide: Annuities; Parties to an Annuity; Accumulation Period; Annuitization Period; Payout Options.


                                                                                                            NEW QUESTION # 52
                                                                                                            An applicant submits the first premium with a life insurance application and receives a conditional receipt.
                                                                                                            When does coverage generally become effective?

                                                                                                            Answer: C

                                                                                                            Explanation:
                                                                                                            A conditional receipt may provide temporary coverage from the application date or medical-examination date, but only if the conditions stated in the receipt are satisfied. A common condition is that the insurer, applying its normal underwriting standards, would have issued the policy to the applicant as applied for or at the requested rating. The receipt does not guarantee coverage for every applicant merely because the first premium was submitted.
                                                                                                            The exact effect of a conditional receipt depends on its language. Some receipts use an "approval" approach, under which coverage begins only when the insurer approves the application. Others use an "insurability" approach, under which coverage may relate back to an earlier date if the applicant was insurable under the insurer's standards. A producer must not describe a conditional receipt as an unconditional binder or promise that the policy has been issued.
                                                                                                            The producer should collect and transmit premium funds according to insurer instructions, deliver the receipt, explain its limited nature, and avoid making coverage representations outside the receipt's terms. If the insurer declines the application, the premium is ordinarily returned according to the applicable procedure.
                                                                                                            Proper explanation is especially important because applicants may assume that payment alone creates permanent insurance.
                                                                                                            References/topics from the Study Guide: Conditional Receipt; Premium with Application; Temporary Insurance; Underwriting Approval; Policy Delivery.


                                                                                                            NEW QUESTION # 53
                                                                                                            A life insurance policy owner has paid $1,200 in premiums in six months for a $250,000 policy. The policyowner dies suddenly and the insurer pays the beneficiary $250,000. This exchange of unequal values reflects which of the following insurance contract features?

                                                                                                            Answer: A

                                                                                                            Explanation:
                                                                                                            An insurance contract is aleatory because the values exchanged by the parties may be unequal and depend on an uncertain event. Choice A is correct. In this example, the policyowner paid only $1,200 in premiums before death, while the insurer paid a $250,000 death benefit. The insurer's obligation was much greater than the premium amount received because the insured event occurred early in the policy period. If death had not occurred for many years, the total premiums paid could have been much closer to or greater than the eventual benefit value. That uncertainty is the defining aleatory feature. A personal contract is based on the insured's individual characteristics and insurable interest. A unilateral contract means only the insurer makes a legally enforceable promise to perform after the applicant accepts the contract and pays premium. A conditional contract requires stated conditions, such as premium payment and proof of loss, to be met before performance is due. None of those terms focuses on the unequal exchange demonstrated here. Study Guide References
                                                                                                            /Topics: Policy Provisions, Clauses, and Riders; Insurance Contract Characteristics; Aleatory Contracts.


                                                                                                            NEW QUESTION # 54
                                                                                                            A person insured under a policy of Long Term Care insurance issued pursuant to a direct response solicitation has how many days after delivery to return the policy for a full refund?

                                                                                                            Answer: D

                                                                                                            Explanation:
                                                                                                            A long-term care insurance policy may be returned within 30 days after delivery for a full premium refund if the applicant is dissatisfied for any reason. This is known as a free-look or right-to-return provision. It gives the insured time to examine the contract after delivery and determine whether the coverage is appropriate.
                                                                                                            The right is especially important in a direct-response sale, where the consumer may not have met face-to-face with a producer. Long-term care policies can contain detailed provisions concerning benefit triggers, elimination periods, activities of daily living, cognitive impairment, benefit periods, inflation protection, exclusions, premium changes, and nonforfeiture benefits. The 30-day review period allows a buyer to examine those terms without forfeiting premium.
                                                                                                            The policy must prominently disclose the right to return the contract and receive a refund. The insurer must make the refund within the required period after the policy is returned. This rule differs from other health- insurance free-look, cancellation, grace-period, and reinstatement provisions, which can use different deadlines.
                                                                                                            Study Guide references/topics: long-term care insurance; direct response solicitation; free-look provision; return of policy; NAC 687B.060 .


                                                                                                            NEW QUESTION # 55
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