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| Section | Weight | Objectives |
|---|---|---|
| Topic 1: Nevada Statutes and Codes Common to Life, Health, Property, and Casualty Insurance | 20% | - Insurance Commissioner
|
| Topic 2: Nevada Statutes and Codes Common to Life and Health Insurance Only | 4% | - Credit life and health insurance - Advertising - Group life and health insurance
|
| Topic 3: Nevada Statutes and Codes Pertinent to Health Insurance Only | 14% | - Medicare
- Coverage for reconstructive surgery - Hospice care - Long Term Care - Mandatory policy clauses and provisions
|
| Topic 4: Accident & Health – General Knowledge | 50% | - Field Underwriting Procedures
|
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NEW QUESTION # 51
Insurance for the primary purpose of repaying a loan in the event of disability is referred to as:
Answer: D
Explanation:
Credit Accident and Health insurance is insurance on a debtor that provides indemnity for payments or debt becoming due on a specific loan or credit transaction while the debtor is disabled as defined by the policy. Its primary purpose is to protect the borrower and creditor by helping repay the outstanding debt when disability prevents the borrower from working or making scheduled payments.
The coverage may pay periodic loan installments during a qualifying disability or, depending on policy design, provide benefits related to the unpaid debt. It is connected to a specific credit obligation rather than serving as broad disability-income protection. The benefit is limited by the loan terms, policy provisions, waiting period, disability definition, and maximum benefit duration.
Guaranteed Asset Protection, or GAP, generally addresses the difference between an automobile's outstanding loan balance and its actual cash value after a covered total loss. Credit life insurance pays or reduces debt upon the debtor's death, not disability. "Loan Repayment policy" is not the standard statutory insurance term.
The examination distinction is that disability-related loan protection is Credit Accident and Health insurance, while death-related loan protection is Credit Life insurance.
Study Guide references/topics: credit insurance; disability protection; credit accident and health insurance; debtor; NRS 690A.0135 .
NEW QUESTION # 52
A life insurance policy owner has paid $1,200 in premiums in six months for a $250,000 policy. The policyowner dies suddenly and the insurer pays the beneficiary $250,000. This exchange of unequal values reflects which of the following insurance contract features?
Answer: D
Explanation:
An insurance contract is aleatory because the values exchanged by the parties may be unequal and depend on an uncertain event. Choice A is correct. In this example, the policyowner paid only $1,200 in premiums before death, while the insurer paid a $250,000 death benefit. The insurer's obligation was much greater than the premium amount received because the insured event occurred early in the policy period. If death had not occurred for many years, the total premiums paid could have been much closer to or greater than the eventual benefit value. That uncertainty is the defining aleatory feature. A personal contract is based on the insured's individual characteristics and insurable interest. A unilateral contract means only the insurer makes a legally enforceable promise to perform after the applicant accepts the contract and pays premium. A conditional contract requires stated conditions, such as premium payment and proof of loss, to be met before performance is due. None of those terms focuses on the unequal exchange demonstrated here. Study Guide References
/Topics: Policy Provisions, Clauses, and Riders; Insurance Contract Characteristics; Aleatory Contracts.
NEW QUESTION # 53
One key distinction between producers and Exchange Enrollment Facilitator (EEF) is producers:
Answer: D
Explanation:
A licensed producer may recommend a health plan for a consumer because the producer is authorized to sell, solicit, and negotiate insurance. That authority permits the producer to discuss coverage choices in a personalized manner, explain how plan provisions apply to the consumer's situation, and recommend a particular policy or plan when appropriate.
An Exchange Enrollment Facilitator is certified to help consumers enroll in qualified health plans through the Exchange. The EEF role is designed to provide impartial enrollment assistance, application support, and general program information. However, an EEF may not sell, solicit, or negotiate insurance. That restriction prevents an EEF from functioning as an insurance producer or steering a consumer toward a particular carrier or plan.
Explaining general terminology, such as deductibles, copayments, and eligibility rules, can be part of enrollment assistance and is not the defining distinction. Compensation is also not the key answer because the legal distinction turns on insurance authority, not simply whether a person receives payment. A Nevada EEF also may not concurrently hold a producer license.
Study Guide references/topics: Exchange Enrollment Facilitators; producer authority; solicitation and negotiation; NRS Chapter 695J .
NEW QUESTION # 54
In order for a health insurance producer to be an Exchange Enrollment Facilitator (EEF), the producer:
Answer: C
Explanation:
A person may not concurrently hold a Nevada producer license and an Exchange Enrollment Facilitator certificate. Therefore, a health insurance producer who wishes to become an EEF must surrender the producer authority and apply for certification as an Exchange Enrollment Facilitator.
An EEF assists consumers with enrollment in qualified health plans offered through the Exchange. The role is designed to provide objective enrollment help, application assistance, and general information. An EEF may not sell, solicit, or negotiate insurance. The EEF also may not receive consideration from a health insurance issuer or insurer in connection with enrollment and may not receive remuneration arising from EEF activities from a licensed producer, insurance consultant, surplus lines broker, or insurer.
For that reason, a producer cannot receive commissions while acting as an EEF, cannot collect both commission and EEF compensation in the manner described, and cannot steer a consumer toward a particular coverage choice. Producers and EEFs have different legal roles, compensation structures, and consumer- protection limitations.
Study Guide references/topics: Exchange Enrollment Facilitators; producer licensing; prohibited acts; compensation; NRS 695J.210 .
NEW QUESTION # 55
Under a group health policy, which of the following coverages MUST be provided for newborn children?
Answer: C
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
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NEW QUESTION # 56
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