InsNV_Health02 Valid Study Questions, InsNV_Health02 Dumps PDF

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

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Insurance Licensing NV Accident and Health Sample Questions (Q106-Q111):

NEW QUESTION # 106
The maximum cost share for preventive screening from an in-network provider is:

A. 10%
B. 0%
C. 30%
D. 20%

Answer: B

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 # 107
The Nevada Life and Health Insurance Guaranty Association becomes involved in an insurance company ' s affairs when the company:

A. enters a lawsuit against a claimant
B. withdraws as an Association member
C. denies a claim
D. becomes insolvent

Answer: D

Explanation:
The Nevada Life and Health Insurance Guaranty Association becomes involved when a covered member insurer becomes impaired or insolvent. Its statutory purpose is to provide limited protection to eligible policyowners, certificate holders, enrollees, beneficiaries, and other covered persons when a member insurer cannot perform its contractual obligations because of financial failure.
An ordinary lawsuit, claim denial, or membership withdrawal does not by itself trigger Guaranty Association protection. Claim disputes are normally handled through the insurer's claims process, internal appeals, administrative complaint procedures, or litigation. The Guaranty Association is not a general claims-review agency.
When a member insurer is impaired or insolvent, the Association may guarantee, assume, reissue, or reinsure covered policies and contracts, or provide other support necessary to meet covered obligations. Coverage is subject to statutory limits, eligibility requirements, exclusions, and residency rules. It does not protect every type of policy or every amount of loss.
Insurers must not use the Association as a sales inducement. Consumers should evaluate an insurer's financial strength and coverage terms rather than assume that all benefits are fully guaranteed.
Study Guide references/topics: insurer insolvency; impaired insurer; Guaranty Association; member insurers; NRS Chapter 686C .

NEW QUESTION # 108
For which of the following losses would an insurance company MOST likely pay benefits under an Accidental Death and Dismemberment policy?

A. Loss of the spleen due to an accidental injury
B. Partial paralysis due to a stroke
C. Loss of life due to a heart attack
D. Loss of eyesight due to an accidental injury

Answer: D

Explanation:
Choice B is correct because accidental loss of eyesight is a standard covered dismemberment loss under most AD & D policies. These policies pay benefits for accidental death and for specifically listed losses, often including loss of life, both hands, both feet, one h and and one foot, sight in one or both eyes, hearing, speech, or specified paralysis. The loss must result directly from accidental bodily injury and occur within the policy's required loss period. Death from a heart attack is generally illness-related rather than accidental. Loss of the spleen, even when caused by an accident, is not usually one of the specifically scheduled losses in a basic AD
& D policy. Partial paralysis due to a stroke is caused by illness rather than accidental injury. AD & D policies are limited-benefit contracts, so the policy does not pay merely because an injury is serious; the loss must match the policy's defined covered loss. The benefit amount varies according to the loss, with full principal sums often payable for death or loss of both eyes and smaller percentages for certain partial losses.
Study Guide References/Topics: Types of Health Insurance Policies; Accidental Death and Dismemberment; Covered Losses.

NEW QUESTION # 109
Under an Accidental Death and Dismemberment policy, in which of the following circumstances will an autopsy NOT be performed?

A. When the cause of death was an accident
B. When the beneficiary refuses to give consent
C. When the cause of death was an illness
D. When it is prohibited by law

Answer: D

Explanation:
The correct answer is B. An AD & D policy may give the insurer the right to conduct an autopsy when death occurs, provided the autopsy is not prohibited by law. The autopsy provision helps the insurer determine whether the cause of death falls within the policy's accidental-death coverage and whether an exclusion applies. A beneficiary's refusal does not necessarily defeat the insurer's contractual right if applicable law permits the examination. The fact that death resulted from illness rather than an accident may affect whether an AD & D benefit is payable, but it does not itself state the legal restriction on performing an autopsy.
Likewise, an accidental cause of death is precisely the type of circumstance in which the insurer may need medical evidence to verify coverage. The insurer's right is not unlimited: it must comply with legal requirements, including restrictions imposed by statute, court order, or other controlling authority. The exam rule is straightforward: the insurer may conduct an autopsy at its own expense unless doing so is prohibited by law. Study Guide References/Topics: Policy Provisions, Clauses, and Riders; Accidental Death and Dismemberment; Autopsy Provision.

NEW QUESTION # 110
Nevada insurance laws define a domestic insurance company as one formed under the laws of:

A. any territory of the United States of America
B. the state of Nevada only
C. the state of Nevada as well as any of its neighboring states
D. any jurisdiction of the United States of America

Answer: B

Explanation:
A domestic insurer in Nevada is an insurer formed under the laws of Nevada, unless it has converted to foreign-insurer status. Therefore, "the state of Nevada only" is the correct answer.
The terms domestic, foreign, and alien describe the jurisdiction in which an insurer is formed or domiciled; they do not describe the insurer's size, financial condition, or whether it is authorized to do business in Nevada. A foreign insurer is formed under the laws of another jurisdiction, generally another U.S. state, but may be authorized to transact insurance in Nevada. An alien insurer is formed under the laws of a country other than the United States.
An insurer may be domestic in one state and foreign in every other state. For example, an insurer incorporated under Nevada law is domestic in Nevada but foreign in California, Arizona, or any other state. Conversely, a company formed in another state is foreign in Nevada even if it holds a Nevada certificate of authority.
Study Guide references/topics: domestic insurers; foreign insurers; alien insurers; insurer domicile; NRS
679A.090 .

NEW QUESTION # 111
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P.S. Free 2026 Insurance Licensing InsNV_Health02 dumps are available on Google Drive shared by PracticeMaterial: https://drive.google.com/open?id=1hkiksjpWFg3fa3c_VxdOFvaWeDcNsU1L