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| Section | Weight | Objectives |
|---|---|---|
| Topic 1: Nevada Statutes, Rules and Regulations | ~32% | - General State Insurance Regulations
|
| Topic 2: Accident and Health — General Knowledge | ~68% | - Policy Provisions, Clauses & Riders
|
>> Examcollection Insurance Licensing InsNV_Health02 Questions Answers <<
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NEW QUESTION # 31
The Nevada Life and Health Insurance Guaranty Association is financed by which of the following methods?
Answer: C
Explanation:
The Nevada Life and Health Insurance Guaranty Association is financed through assessments on member insurance companies. Insurers authorized to transact covered life, health, or annuity business in Nevada are members of the Association as a condition of their authority to operate in the state. When an assessment is necessary, the Association assesses member insurers according to the statutory assessment system.
The Association exists to provide limited protection when a member insurer becomes impaired or insolvent and cannot meet covered contractual obligations. It is not financed by direct assessments against insureds, policyowners, agents, or association members. It is also not simply funded through a general premium tax imposed on consumers.
Nevada law establishes assessment classes, including assessments for administrative and legal expenses and assessments needed to carry out the Association's obligations regarding an impaired or insolvent insurer.
Member insurers may consider the cost of assessments when establishing rates and dividends, but that does not change the source of the Association's direct funding: the member insurers themselves.
The Guaranty Association is a safety mechanism with statutory limits. It is not a substitute for evaluating an insurer's financial strength, and insurers and producers may not use its existence as a sales inducement.
Study Guide references/topics: insurer insolvency; guaranty associations; member insurer assessments; NRS Chapter 686C .
NEW QUESTION # 32
Which underwriting duty is most directly performed by a producer during a life insurance application interview?
Answer: B
Explanation:
A producer performs field underwriting by gathering complete and accurate application information, explaining questions to the applicant without coaching answers, observing relevant facts, and submitting the application promptly to the insurer. Relevant observations may include obvious health conditions, the applicant's demeanor, financial circumstances, hazardous occupation or avocation information, and whether answers appear complete and consistent. The producer must report material information obtained in the course of the sale rather than deciding independently that an unfavorable fact is unimportant.
The insurer, not the producer, makes the final underwriting decision. The insurer may use the application, medical records, attending-physician statements, inspection reports, prescription-history reports, credit-related information where permitted, and other lawful underwriting tools. Based on that review, the insurer may issue the policy as applied for, issue it with a rating or modification, postpone it, or decline it.
A producer must never alter an applicant's answers, conceal material information, or sign an application for an applicant without authority. Accurate field underwriting protects the applicant, insurer, producer, and beneficiaries by reducing the risk of misrepresentation, rescission, claim disputes, or regulatory action. The producer's role is factual collection and proper submission-not final risk selection.
References/topics from the Study Guide: Field Underwriting; Application Completion; Producer Responsibilities; Insurer Underwriting; Material Facts.
NEW QUESTION # 33
Under the Affordable Care Act (ACA), for a woman 40 years or older, mammograms are:
Answer: B
Explanation:
For insured women age 40 or older, Nevada requires group health insurance coverage for an annual mammogram to screen for breast cancer. The required benefit must be available through an in-network provider, and the insurer generally may not impose a deductible, copayment, coinsurance, or another form of cost sharing for that mandated screening.
Mammography is preventive screening. It is intended to detect breast cancer early, often before symptoms appear. This differs from diagnostic imaging, which may be ordered after an abnormal screening result, a finding on examination, or another clinical concern. Nevada law also addresses medically necessary imaging and diagnostic testing when the insured's provider recommends them based on medical history, family history, risk factors, or an observed abnormality.
A family history of breast cancer does not eliminate coverage; instead, it may support the need for additional screening or imaging. The benefit is not restricted only to plans that voluntarily choose to offer mammography. It is a required coverage provision for applicable group health policies.
Study Guide references/topics: preventive care; breast-cancer screening; mandated benefits; deductibles and coinsurance; NRS 689B.0374 .
NEW QUESTION # 34
Under a group health policy, which of the following coverages MUST be provided for newborn children?
Answer: B
Explanation:
Nevada requires qualifying group health policies that cover family members to provide coverage for a newborn child from the moment of birth. Required newborn coverage includes injury or sickness and specifically includes the necessary care and treatment of medically diagnosed congenital defects and birth abnormalities. Therefore, congenital health defects are the required coverage identified in this question.
The rule is important because congenital defects may be present at birth and can require immediate diagnostic, surgical, medical, or hospital treatment. Nevada law prevents a policy from excluding this necessary care simply because the condition existed at birth. The statute also prohibits exclusion of premature births under the applicable coverage requirement.
The transportation option is incorrect because the law addresses necessary transportation from the place of birth to the nearest specialized treatment center, within policy limits; it does not mandate transportation from the hospital to the child's residence. Routine eye examinations and genetic testing may be covered under a particular policy or health plan, but they are not the specific newborn mandate tested here. Continued coverage beyond the initial period may depend on timely notice and payment of required premium within 31 days.
Study Guide references/topics: group health insurance; newborn coverage; mandated benefits; NRS 689B.033
.
NEW QUESTION # 35
The Nevada Insurance Commissioner may revoke the license of any licensed producer who:
Answer: A
Explanation:
Misappropriating money belonging to policyholders is a direct and serious ground for license revocation. A producer commonly receives premiums, return premiums, claim funds, or other property in the course of insurance business. Those funds must be handled honestly, promptly, and in accordance with the producer's fiduciary responsibilities. Using, converting, improperly withholding, or diverting that money violates Nevada producer-licensing law.
The Commissioner may refuse to issue, suspend, revoke, or refuse to renew a producer's license and may impose administrative fines or other disciplinary action for specified misconduct. Misappropriation is specifically identified as conduct warranting discipline because it threatens consumers and undermines the integrity of the insurance marketplace.
A civil judgment alone does not automatically establish a licensing-revocation ground under the wording of this question. Likewise, reporting requirements and address-change obligations may lead to administrative consequences when violated, but the question asks for the clear statutory cause for revocation.
Misappropriation of policyholder money is the most direct and legally significant answer.
Producers should maintain accurate premium records, promptly remit funds, segregate money when required, and never treat policyholder or insurer funds as personal assets.
Study Guide references/topics: producer fiduciary duties; prohibited practices; license denial, suspension, and revocation; NRS 683A.451 .
NEW QUESTION # 36
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