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| Section | Weight | Objectives |
|---|---|---|
| Topic 1: Nevada Statutes, Rules and Regulations | ~32% | - Nevada Health-Specific Regulations
|
| Topic 2: Accident and Health — General Knowledge | ~68% | - Policy Provisions, Clauses & Riders
|
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NEW QUESTION # 63
Which statement best describes a group life conversion privilege?
Answer: D
Explanation:
A group life conversion privilege allows an insured whose group coverage terminates to obtain an individual life insurance policy without providing new evidence of insurability, provided the person applies and pays the required premium within the conversion period. The privilege is valuable because a person leaving employment may have become less insurable since original enrollment. Conversion allows continued life coverage despite a change in health, although the individual policy's premium is generally based on the insurer's conversion rates and may be higher than the group rate.
The group master policy and applicable law control the conversion period, maximum conversion amount, and type of individual policy available. The individual policy may not be identical to the group coverage. A producer should explain that the former employee has a limited window to act and should review alternative coverage options promptly.
Conversion differs from portability. Portability allows an insured to continue group-style coverage under certain terms, while conversion results in a new individual policy. The protection during the conversion period is also significant: Nevada group-life law provides a death benefit if the insured dies during the conversion period before the individual policy becomes effective, in the amount that could have been converted.
References/topics from the Study Guide: Group Life Insurance; Conversion Privilege; Portability; Termination of Group Coverage; NRS 688B.120-688B.130.
NEW QUESTION # 64
The maximum cost share for preventive screening from an in-network provider is:
Answer: C
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 # 65
An insurer shall not issue an individual long-term care insurance contract in Nevada unless the insurer has received from the applicant:
Answer: A
Explanation:
Nevada requires an individual long-term care insurer to obtain a written designation of at least one additional person who will receive notice if coverage is about to lapse or terminate for nonpayment of premium. This protection is intended to reduce unintended lapses, particularly when an insured experiences cognitive decline, illness, disability, or another circumstance that interferes with managing premiums.
The applicant may instead submit a written waiver, dated and signed, stating that the applicant chooses not to designate another person. The waiver is not required to be notarized. Because option B incorrectly adds a notarization requirement, option A is the best answer as written.
The designated person does not become responsible for paying premiums and does not assume liability for the applicant's care. The person's role is simply to receive notice, allowing the person an opportunity to alert the insured or help address an overlooked payment. Payroll or pension deduction is not a required payment method.
Before an individual long-term care policy can lapse for nonpayment, notice requirements apply to both the policyholder and the designated person. This is a key long-term-care consumer-protection provision.
Study Guide references/topics: long-term care insurance; lapse protection; nonpayment of premium; designation of another person; NAC 687B.0681 .
NEW QUESTION # 66
An individual health insurance policy contains a Change of Occupation provision. If the insured experiences a loss in a more hazardous occupation than when the policy was issued, the insurance company may:
Answer: D
Explanation:
The Change of Occupation provision allows an insurer to adjust benefits when the insured changes to a more hazardous occupation after policy issue. Choice A is correct. If the same premium would have purchased a lower benefit amount for the new, more hazardous occupati on, the insurer may reduce the benefit to the amount that premium would have bought under the new occupational classification. The purpose is to preserve fairness between the risk assumed and the premium paid without automatically cancelling the policy.
The insurer does not simply increase the waiting period or deductible, because those are not the contractual adjustment method addressed by the provision. It also does not deny every claim for misrepresentation, because a later change in occupation is not necessarily a misrepresentation in the original application. If the insured changes to a less hazardous occupation, the provision may allow the insured to apply for an adjusted premium rate or greater benefit as appropriate under policy terms. The key examination rule is that occupational changes affect the amount of benefits or premium classification, not the basic validity of coverage. Study Guide References/Topics: Policy Provisions, Clauses, and Riders; Change of Occupation Provision; Individual Accident and Health Policies.
NEW QUESTION # 67
In a variable annuity, who bears the investment risk associated with the separate-account investment performance?
Answer: A
Explanation:
In a variable annuity, the contract owner bears the investment risk because contract values are tied to the performance of selected investment options held in a separate account. If those investments perform well, the accumulation value may increase. If they decline, the account value may decrease. The insurer does not guarantee a fixed return on the separate-account portion of the contract, although the contract may include certain insurance guarantees, such as a death-benefit feature or optional living benefits.
This is the central distinction between fixed and variable annuities. A fixed annuity generally credits interest at a guaranteed minimum rate and may declare additional interest under the contract terms. The insurer bears the investment risk for its general account. A variable annuity offers market-based investment choices and transfers market risk to the owner. Because variable annuity values are securities-linked, the producer must also satisfy applicable securities-registration and licensing requirements in addition to life insurance authority.
The suitability analysis is important. Variable annuities may be appropriate for a consumer seeking long-term growth potential who understands market volatility and has an appropriate time horizon. They are not automatically appropriate for a person who requires principal stability, liquidity, or predictable fixed returns.
References/topics from the Study Guide: Fixed Annuities; Variable Annuities; Separate Accounts; General Accounts; Investment Risk; Suitability.
NEW QUESTION # 68
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