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Insurance Licensing InsNV_Health02 Exam Syllabus Topics:

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

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It-PassportsのInsurance Licensing InsNV_Health02認定試験に対する最高の参考書

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Insurance Licensing NV Accident and Health 認定 InsNV_Health02 試験問題 (Q76-Q81):

質問 # 76
Group coverage for a handicapped dependent child may be continued if the primary insured submits the required proof to the insurance company within what MAXIMUM period of time after the child reaches the limiting age?

A. 30 days
B. 15 days
C. 45 days
D. 31 days

正解：D

解説：
A group health policy that terminates dependent-child coverage at a stated limiting age must continue coverage for an eligible dependent child who remains incapable of self-sustaining employment because of a qualifying disability and who remains dependent on the insured group member for support and maintenance.
To preserve that continuation right, the required proof must be furnished within 31 days after the child reaches the policy's limiting age.
This is a time-sensitive protection. The purpose is to prevent automatic termination of coverage solely because a dependent reaches the normal age limit when the child remains disabled and financially dependent.
After initial proof is provided, the insurer may require continuing proof of incapacity and dependency, but it may not demand that proof more often than permitted by law.
The 31-day rule should be distinguished from notice periods for newborn coverage, conversion rights, premium grace periods, and claim notices. Each insurance provision may use a different time period, so examination questions often test the exact statutory deadline.
Study Guide references/topics: group health dependents; limiting age; continuation of coverage; NRS 689B.
035 .

質問 # 77
A $100,000 group Accidental Death and Dismemberment policy will pay double indemnity if the insured dies in a commercial airplane crash. If the insured is killed when flying to a business meeting on a commercial flight, the policy will pay a MAXIMUM of:

A. $0
B. $300,000
C. $200,000
D. $100,000

正解：C

解説：
The correct answer is C, $200,000. The policy's principal sum is $100,000, and the double-indemnity provision pays twice that amount when death results from the stated qualifying accident: a commercial airplane crash. Because the insured was flying on a commercial flight and was killed in the crash, the maximum payable benefit is two times $100,000, or $200,000. The fact that the trip was to a business meeting does not reduce the benefit under the facts given. Choice A would be appropriate only if an exclusion applied, such as an excluded type of aviation activity. Choice B states only the policy's base amount and ignores the double-indemnity provision. Choice D incorrectly adds an additional amount beyond the stated double benefit. AD & D coverage pays only when the loss falls within the policy's accidental-loss definition and occurs within any stated loss period. Aviation wording matters: commercial passenger travel is commonly covered, while piloting, crew duties, private aircraft, or military aviation may be treated differently under the contract. Study Guide References/Topics: Group Health Insurance; Accidental Death and Dismemberment; Double Indemnity.

質問 # 78
A policyowner borrows money from the insurer using the cash value of a whole life policy as security. If the loan and accrued interest are unpaid when the insured dies, what is the usual result?

A. The death benefit is reduced by the outstanding loan and interest.
B. The insurer cancels the policy immediately when the loan is made.
C. The beneficiary receives the full death benefit and the loan is forgiven.
D. The cash value is transferred automatically to the beneficiary instead of the death benefit.

正解：A

解説：
A policy loan is a loan made by the insurer to the policyowner and secured by the policy's available cash value. It is not a withdrawal that automatically terminates the coverage. However, the outstanding principal and accrued interest become indebtedness against the policy. If the insured dies before repayment, the insurer deducts that indebtedness from the amount otherwise payable to the beneficiary. Therefore, the usual result is a reduced death benefit.
This concept is especially important with permanent life insurance, including whole life and certain universal- life policies, because cash value may support policy loans. Interest continues to accrue under the policy's loan provision. If the debt becomes large enough, it can threaten the policy's continuation because a lapse may occur if the cash value is insufficient to support the indebtedness and required charges. A producer should explain both the availability of loans and their consequences; presenting a loan as "free money" would be misleading.
Nevada's life-insurance standards require a loan provision in policies to which the requirement applies. The contractual terms control such matters as interest, notice, repayment, and the effect of indebtedness on policy values and proceeds.
References/topics from the Study Guide: Cash Value; Policy Loans; Nonforfeiture Values; NRS 688A.110- Loan Secured by Policy.

質問 # 79
An insurer shall not issue an individual long-term care insurance contract in Nevada unless the insurer has received from the applicant:

A. a written designation by the applicant to pay premium for long-term care insurance through either a payroll or pension deduction plan
B. a designation by at least one person, in addition to the applicant, to accept liability for services provided to the applicant
C. a notarized waiver dated and signed by the applicant stating that the applicant has chosen not to designate another person to receive notice of any lapse or termination of coverage for nonpayment of premium
D. a written designation of at least one person, in addition to the applicant, who must receive notice of any lapse or termination of coverage under the policy for nonpayment of premium

正解：D

解説：
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 .

質問 # 80
In Nevada, which life insurance policy is subject to a 30-day right to surrender for a premium refund after delivery?

A. A group life certificate
B. A replacement life insurance policy
C. An industrial life policy
D. A standard nonreplacement life insurance policy

正解：B

解説：
A replacement life insurance policy delivered in Nevada must provide a 30-day period during which the policyowner may surrender the policy to the insurer with a written request for cancellation and receive a refund of premiums paid, including policy fees or other charges. This longer review period recognizes the special risks associated with replacement transactions. Replacing existing coverage can cause the consumer to lose favorable values, restart contestability or suicide periods, incur surrender charges, or exchange a policy that better serves the client's long-term needs.
For a nonreplacement life policy, annuity contract, or pure endowment contract, Nevada generally requires a
10-day right of surrender after delivery. The applicable statute excludes industrial life insurance from this requirement. The producer must therefore identify whether a proposed transaction is a replacement and follow the related disclosure and recordkeeping requirements. The free-look period is a consumer-protection right; it does not excuse a producer from determining suitability or accurately comparing existing and proposed coverage before the sale.
On an examination question, the key distinction is not whether the policy is whole life, term life, or universal life. The key is whether it is a replacement contract or policy.
References/topics from the Study Guide: Replacement; Free-Look Provision; Nevada Consumer Protections; NRS 688A.165.

質問 # 81
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