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Insurance Licensing InsNV_Health02 Exam Syllabus Topics:

SectionWeightObjectives
Topic 1: Accident and Health — General Knowledge~68%- Insurance Concepts and Underwriting
  • 1. Premiums and Renewal
  • 2. Application and Underwriting
  • 3. Insurance Basics and Risk
- Policy Provisions, Clauses & Riders
  • 1. Mandatory Uniform Provisions
  • 2. Common Riders
  • 3. Optional Provisions
  • 4. Other Provisions and Clauses
- Types of Health Insurance Policies
  • 1. Limited Benefit Plans
  • 2. Group Health Insurance
  • 3. Disability Income Insurance
  • 4. Medicare Supplement Policies
  • 5. Long-Term Care (LTC) Insurance
  • 6. Medical Expense / Major Medical Insurance
  • 7. Accidental Death & Dismemberment
- Social Insurance / Government Plans
  • 1. Medicare (Parts A, B, C, D)
  • 2. Social Security Disability Benefits
  • 3. Medicaid
Topic 2: Nevada Statutes, Rules and Regulations~32%- General State Insurance Regulations
  • 1. Definitions and General Provisions
  • 2. Insurance Commissioner Authority
  • 3. Agent Licensing Requirements
  • 4. Insurance Guaranty Associations
  • 5. Marketing Practices and Unfair Trade
- Nevada Health-Specific Regulations
  • 1. Advertising and Disclosure Rules
  • 2. Replacement and Free-Look Provisions
  • 3. Group and Credit Health Rules

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Insurance Licensing NV Accident and Health Sample Questions (Q112-Q117):

NEW QUESTION # 112
A producer aggrieved by any regulation or order of the Insurance Commissioner may request:

Answer: B

Explanation:
A producer who is aggrieved by a regulation or order of the Nevada Insurance Commissioner may request an administrative hearing. Nevada law requires the Commissioner to hold a hearing upon a proper written application from a person aggrieved by an act, failure to act, report, rule, regulation, or order related to the business of insurance, subject to statutory timing and procedural requirements.
The request is a due-process mechanism. It gives the affected producer an opportunity to state the grounds for relief, present evidence, challenge the factual or legal basis of the regulatory action, and create an administrative record. The application must generally be filed with the Division within 60 days after the person knew or reasonably should have known of the action, unless another law establishes a different period.
The Secretary of State does not provide the administrative remedy described in this question. Legislative review and peer review are not the standard appeal mechanisms for an individual Commissioner action.
Judicial review may become available after the administrative process, but the immediate remedy tested here is the request for an administrative hearing.
Study Guide references/topics: Commissioner authority; hearings; producer rights; administrative due process; NRS 679B.310 .


NEW QUESTION # 113
Which of the following groups is NOT eligible to purchase blanket health insurance to cover its members for a specific event or activity?

Answer: B

Explanation:
A family is not an eligible blanket-health-insurance group under Nevada law. Blanket accident and health insurance is designed for defined groups connected by a common activity, organization, occupation, event, or exposure to a specified hazard. It is not designed as a substitute for ordinary individual or family health insurance.
Nevada specifically recognizes various groups that may be covered under a blanket policy. These include religious, charitable, recreational, educational, and civic organizations; newspaper publishers covering their carriers; and volunteer fire departments or similar emergency organizations covering members or participants.
The organization acts as the policyholder, and the covered persons are defined by their relationship to the group activity or specified hazard.
A church is eligible as a religious organization. A newspaper corporation may qualify when covering its carriers. A volunteer fire department is specifically listed as an eligible organization. A family, however, is a private household relationship rather than a qualifying blanket group formed around an authorized organizational purpose or activity.
Study Guide references/topics: blanket accident and health insurance; eligible groups; policyholder; specified hazards; NRS 689B.070 .


NEW QUESTION # 114
The maximum cost share for preventive screening from an in-network provider is:

Answer: D

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 # 115
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?

Answer: A


NEW QUESTION # 116
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 # 117
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