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| Section | Weight | Objectives |
|---|---|---|
| Topic 1: Accident & Health – General Knowledge | 50% | - Social Insurance
|
| Topic 2: Nevada Statutes and Codes Pertinent to Health Insurance Only | 14% | - Coverage for reconstructive surgery - Long Term Care - Mandatory policy clauses and provisions
- Availability of coverage for mental health and treatment of alcohol abuse and drug abuse - Medicare
|
| Topic 3: Nevada Statutes and Codes Common to Life and Health Insurance Only | 4% | - Advertising - Group life and health insurance
|
| Topic 4: Nevada Statutes and Codes Common to Life, Health, Property, and Casualty Insurance | 20% | - Marketing Practices
- Insurance Commissioner
|
>> Latest Study InsNV_Health02 Questions <<
You can avail all the above-mentioned characteristics of the desktop software in this web-based Insurance Licensing InsNV_Health02 practice test. While you appear in the Insurance Licensing InsNV_Health02 real examination, you will feel the same environment you faced during our Insurance Licensing InsNV_Health02 practice test.
NEW QUESTION # 26
A producer receives a phone call from an insured who already has health insurance and now wants to buy an Accidental Death and Dismemberment (AD & D) policy. In this situation, the producer should take which of the following actions?
Answer: B
Explanation:
The application is a material underwriting document, so the producer must use a process that obtains accurate information and a valid applicant signature before submission. Choice D is correct because the producer should meet with the prospect, have the prospect complete the application, and obtain the prospect's signature. This confirms that the answers are the applicant's statements and that the applicant has reviewed the information before the insurer relies upon it. The producer may explain questions and assist with completion, but should not answer questions on the prospect's behalf. Choice B is improper because the applicant's signature should not be postponed until after insurer approval. Choice C is improper because the producer should not independently answer application questions; the applicant provides the information.
Choice A is less appropriate because it bypasses the producer's opportunity to review the application for completeness, explain disclosures, and verify that required signatures are obtained. The existing health coverage does not eliminate the need for a complete AD & D application. Study Guide References/Topics:
Completing the Application, Underwriting, and Delivering the Policy; Producer Responsibilities; Application Completion.
NEW QUESTION # 27
Under an individual health policy issued in Nevada, a newborn is automatically covered for a MAXIMUM of how many days after birth?
Answer: C
Explanation:
A newborn is automatically covered under the applicable Nevada health-policy rule for 31 days after birth.
Coverage begins from the moment of birth and includes necessary care and treatment for injury or sickness, including medically diagnosed congenital defects and birth abnormalities.
To continue coverage beyond the initial 31-day period, the policy may require timely notice of the birth and payment of any additional premium or fee required by the insurer. The notification and payment requirement must be satisfied within the 31-day period if the policy requires it. This rule protects newborns during the immediate post-birth period, when medical care may be urgently necessary.
The automatic coverage is not limited to routine newborn care. It includes necessary treatment of medical conditions identified at birth, subject to the policy's applicable limits. The law also prevents the policy from excluding premature births under the mandated newborn coverage.
Two, five, and ten days are incorrect because they would not provide the statutory protection required for newborn coverage. The exam point is that the initial automatic period is 31 days, while continuation beyond that period may require prompt enrollment action by the insured.
Study Guide references/topics: individual health insurance; newborn coverage; congenital defects; notification requirements; Nevada newborn-coverage requirements .
NEW QUESTION # 28
The Affordable Care Act (ACA) requires every individual policy to provide minimum coverages known as:
Answer: D
Explanation:
The Affordable Care Act established Essential Health Benefits as the minimum categories of benefits that qualifying individual and small-group health plans must cover. These required benefit categories create a baseline of comprehensive coverage rather than allowing a major medical plan to omit fundamental types of care.
Essential Health Benefits include ambulatory patient services, emergency services, hospitalization, maternity and newborn care, mental health and substance-use-disorder services, prescription drugs, rehabilitative and habilitative services and devices, laboratory services, preventive and wellness services, chronic-disease management, and pediatric services, including oral and vision care.
Gold and Silver are metal-level plan categories. They describe the general actuarial value of a plan-the approximate division of covered health-care costs between the insurer and enrollees-not a separate legal list of mandatory minimum benefits. A Gold plan generally pays a larger share of covered costs than a Silver plan, but both must include the applicable Essential Health Benefits. "Silver Saver Value" and "Medicaid Buy- Back" are not the ACA's required minimum-coverage terminology.
For examination purposes, distinguish the benefit package itself-Essential Health Benefits-from plan metal levels and from public programs such as Medicaid.
Study Guide references/topics: Affordable Care Act; individual health insurance; qualified health plans; Essential Health Benefits; HealthCare.gov coverage protections .
NEW QUESTION # 29
An insured who owns a Disability Income policy forgot to pay the premium due on July 1. If the insured files a disability claim on July 31, the insurance company will MOST likely:
Answer: B
Explanation:
The policy remains in force during its contractual grace period after a premium becomes due. For individual accident and health policies, the required grace period generally depends on premium mode: seven days for weekly premiums, ten days for monthly premiums, and 31 days for other premium modes. A claim occurring within the applicable grace period is not automatically denied simply because the premium has not yet been paid. Instead, the insurer may pay the covered claim and deduct the overdue premium from the amount otherwise payable. Therefore, choice B is the best answer. Reinstatement is unnecessary because the policy has not yet lapsed while the grace period is still running. Cancellation and return of all prior premiums would be inconsistent with the purpose of the grace-period provision. The question tests the difference between a late premium during grace and a lapsed policy after grace expires. Once grace expires without payment, coverage can lapse; if coverage later is reinstated, loss coverage may be subject to reinstatement provisions and limitations. Study Guide References/Topics: Policy Provisions, Clauses, and Riders; Grace Period; Disability Income Insurance.
NEW QUESTION # 30
In a typical HMO arrangement, what is the primary role of the primary care provider?
Answer: B
Explanation:
In a typical health maintenance organization, the primary care provider acts as the central coordinator of the insured's routine medical care. The primary care provider may deliver preventive and basic medical services, maintain the patient's care plan, and refer the patient to specialists or other facilities when required by the HMO's rules. This gatekeeper function is intended to coordinate care, reduce unnecessary duplication, and manage costs through the plan's provider network.
The precise referral rules depend on the particular HMO. Some plans may allow direct access to certain specialists, such as obstetricians or behavioral-health providers, while others require prior referral or authorization. Emergency services are subject to separate protections and should not be described as ordinary out-of-network elective care. The producer must explain the network, referral, prior-authorization, and out-of- network rules before enrollment.
A PPO also has a preferred provider network but commonly allows members to use nonnetwork providers at a reduced benefit level and without the same referral structure. An indemnity plan may provide broader provider choice but may have different reimbursement limits and cost sharing. The test distinction is that an HMO commonly emphasizes coordinated, network-based care through a primary care provider.
References/topics from the Study Guide: Managed Care; HMO; Primary Care Provider; Gatekeeper Model; Provider Networks.
NEW QUESTION # 31
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This offline version of the practice test creates a real NV Accident and Health exam environment. You can practice the Insurance Licensing InsNV_Health02 Questions with the help of desktop practice exam software. The practice exam software is compatible with Windows-based computers only and does not need internet connectivity.
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