The number of questions of the InsNV_Health02 study materials you have done has a great influence on your passing rate. As for our study materials, we have prepared abundant exercises for you to do. You can take part in the real InsNV_Health02 exam after you have memorized all questions and answers accurately. Also, we just pick out the most important knowledge to learn. Through large numbers of practices, you will soon master the core knowledge of the InsNV_Health02 Exam. It is important to review the questions you always choose mistakenly. You should concentrate on finishing all exercises once you are determined to pass the InsNV_Health02 exam.
| Section | Weight | Objectives |
|---|---|---|
| Nevada Statutes and Codes Pertinent to Health Insurance Only | 14% | - Hospice care - Long Term Care - Coverage for reconstructive surgery - Medicare
|
| Nevada Statutes and Codes Common to Life and Health Insurance Only | 4% | - Credit life and health insurance - Advertising - Group life and health insurance
|
| Nevada Statutes and Codes Common to Life, Health, Property, and Casualty Insurance | 20% | - Nevada Life and Health Insurance Guaranty Association - Definitions
|
| Accident & Health – General Knowledge | 50% | - Policy Provisions, Clauses, and Riders
|
>> Reliable InsNV_Health02 Exam Sample <<
To attempt the Insurance Licensing InsNV_Health02 exam optimally and ace it on the first attempt, proper exam planning is crucial. Since the Insurance Licensing InsNV_Health02 exam demands a lot of time and effort, we designed the NV Accident and Health (InsNV_Health02) exam dumps in such a way that you won't have to go through sleepless study nights or disturb your schedule. Before starting the Insurance Licensing InsNV_Health02 Preparation, plan the amount of time you will allot to each topic, determine the topics that demand more effort and prioritize the components that possess more weightage in the Insurance Licensing InsNV_Health02 exam.
NEW QUESTION # 13
Most insurance companies use the usual, customary, and reasonable (UCR) charges to:
Answer: B
Explanation:
Usual, customary, and reasonable charges are payment standards used to determine the portion of a medical charge that a health insurer recognizes as eligible for reimbursement. Choice D is correct because UCR standards limit the insurer's claim liability to an amount considered appropriate for the service in the relevant geographic area. "Usual" refers to the fee commonly charged by a particular provider; "customary" refers to fees generally charged by comparable providers in the area; and "reasonable" considers the circumstances and complexity of the service. If a provider's charge exceeds the plan's allowed amount, the insurer may pay only the UCR amount, and the patient may remain responsible for the difference unless a network agreement or other policy provision prevents balance billing. UCR does not mean that insurers reimburse excess charges, pay funds to employers, or reimburse every amount billed by a medical facility. This concept is tested as a cost-control mechanism within medical expense coverage and should be distinguished from deductibles, coinsurance, copayments, and maximum benefit limits. Study Guide References/Topics: Policy Provisions, Clauses, and Riders; Medical Expense Insurance; Usual, Customary, and Reasonable Charges.
NEW QUESTION # 14
In order to be covered under the Nevada Life and Health Insurance Guaranty Association, an insurance company MUST be:
Answer: D
Explanation:
An insurer must be admitted in Nevada-meaning authorized to transact the applicable insurance business in the state-to be a member of the Nevada Life and Health Insurance Guaranty Association. Membership is a condition of authority for insurers and health maintenance organizations writing the kinds of coverage protected by the Guaranty Association Act.
The Association provides limited protection when a member insurer becomes impaired or insolvent and cannot meet covered contractual obligations. It is not a general guarantee of every insurance company or every policy. Coverage is governed by statute, subject to eligibility requirements, benefit limits, exclusions, and residency provisions.
An AM Best rating is an independent financial-strength opinion. It may be useful to consumers and producers evaluating an insurer, but it does not determine membership in the Guaranty Association. A fraternal benefit society is specifically excluded from the definition of a member insurer for this purpose. "Alien" refers to an insurer organized under the laws of another country and does not, by itself, establish Association membership; the key consideration is whether the insurer is authorized to transact covered insurance in Nevada.
Study Guide references/topics: admitted versus nonadmitted insurers; guaranty associations; insurer insolvency; NRS Chapter 686C .
NEW QUESTION # 15
For a group health plan subject to the federal waiting-period rule, the waiting period for otherwise eligible employees generally may not exceed:
Answer: B
Explanation:
A health plan's waiting period generally may not exceed 90 calendar days for an individual who is otherwise eligible to enroll. A waiting period is the period that must pass before coverage becomes effective for an employee or dependent who has met the plan's substantive eligibility conditions. The rule is intended to limit extended gaps in employer-sponsored health coverage for eligible individuals.
The 90-day limitation does not mean that every new employee must receive coverage immediately on the first day of work. An employer may use reasonable eligibility requirements, such as a bona fide job classification or an hours-of-service requirement, as long as the arrangement is structured and administered in compliance with applicable federal rules. The producer should not treat every orientation period or administrative condition as automatically permissible; plan documents and current legal guidance matter.
This issue is distinct from preexisting-condition exclusions. Modern health-insurance rules significantly restrict the use of preexisting-condition exclusions in major medical coverage. It is also distinct from an elimination period in disability insurance, which is a waiting period after a disability begins rather than a waiting period for plan eligibility.
References/topics from the Study Guide: Group Health Eligibility; Waiting Periods; Employer-Sponsored Coverage; Federal Health-Insurance Requirements; Nevada Group Health Rules.
NEW QUESTION # 16
An insured has a $1,000 deductible and then pays 20% of covered medical expenses, while the insurer pays
80%. What is the insured's 20% share called?
Answer: B
Explanation:
Coinsurance is the percentage of covered expenses that the insured shares with the insurer after the deductible has been satisfied. In this question, the insured pays 20% and the insurer pays 80%; this is commonly described as 80/20 coinsurance. The deductible is separate. It is the amount the insured must pay before the insurer begins sharing covered expenses, subject to any services that the policy covers before the deductible.
A copayment is a fixed dollar amount paid for a covered service, such as a stated amount for a physician visit or prescription. It is not normally expressed as a percentage. An elimination period is a waiting period in disability-income insurance before benefits begin. A stop-loss feature, also called an out-of-pocket maximum in many plans, limits the insured's covered cost sharing after a stated maximum has been reached, subject to plan rules.
Understanding these terms is essential when comparing health plans. A plan may have a lower premium but a higher deductible, greater coinsurance, or a larger out-of-pocket maximum. Producers must clearly explain the consumer's potential financial responsibility and must not imply that the insurer pays every medical expense once a policy is issued.
References/topics from the Study Guide: Major Medical Insurance; Deductibles; Coinsurance; Copayments; Out-of-Pocket Maximums.
NEW QUESTION # 17
An insured who wants to guarantee that an Accident and Health policy will remain in force even in the event of being disabled should purchase which of the following riders?
Answer: B
Explanation:
The Waiver of Premium rider is designed to prevent a disability from causing the insured to lose coverage because premiums cannot be paid. When the rider's qualifying disability conditions are met, the insurer waives future premiums after the applicable waiting period while the disability continues. The policy therefore remains in force without premium payment during the qualifying period. Choice C is correct because it directly addresses continuation of coverage during disability. AD & D pays a benefit for accidental death or specified accidental losses; it does not waive premiums. Double indemnity generally increases the death benefit for a qualifying accidental death and likewise does not preserve health coverage during disability. Guaranteed insurability permits the future purchase of additional coverage without new evidence of insurability, but it does not relieve the policyowner of the duty to pay premiums on existing coverage. The rider's exact definition of disability, elimination period, age limitation, and proof-of-disability requirements are controlled by the policy. Study Guide References/Topics: Policy Provisions, Clauses, and Riders; Disability Income Insurance; Waiver of Premium.
NEW QUESTION # 18
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