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| Section | Objectives |
|---|---|
| Insurance Basics | - Risk Management and Insurance Concepts
|
| Government Health Insurance Programs | - Medicare
|
| Accident and Health Insurance Fundamentals | - Disability Income Insurance
|
| Producer Duties and Ethics | - Ethical Responsibilities
|
| General Insurance Regulation | - Nevada Insurance Department and Regulatory Authority
|
| Health Insurance Policy Provisions | - Mandatory and Optional Provisions
|
>> InsNV_Health02 Exam Questions Answers <<
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NEW QUESTION # 87
Which of the following information is included in the Consideration clause in an Accident and Health policy?
Answer: B
Explanation:
The consideration clause identifies the exchange of value that creates the insurance contract. The insurer's consideration is its promise to provide the stated coverage and pay covered claims. The applicant's consideration consists of the application statements and payment of the required premium. Therefore, choice D is correct because the policy identifies the schedule and amount of premium payments as part of that contractual consideration. The coverage description is found in the insuring clause and benefit provisions.
Contestability is addressed in the time-limit or incontestability provisions. The grace period is stated in a separate mandatory policy provision dealing with late premium payments and continuation of coverage. The consideration clause is important because it establishes that insurance is a reciprocal exchange: the insurer assumes risk in return for the applicant's premium and representations. If the premium is not paid as required, the policy can lapse after the grace period unless another provision applies. The clause also connects the policy and attached application as part of the entire contract, subject to applicable individual accident and health insurance requirements. Study Guide References/Topics: Policy Provisions, Clauses, and Riders; Consideration Clause; Entire Contract.
NEW QUESTION # 88
What is the principal purpose of Medicare supplement insurance?
Answer: D
Explanation:
Medicare supplement insurance, often called Medigap, is designed to help pay certain out-of-pocket costs left by Original Medicare, such as deductibles, coinsurance, copayments, and other covered gaps, depending on the standardized policy type and current rules. It supplements Original Medicare Parts A and B; it does not replace Medicare coverage. The insured must generally remain enrolled in Original Medicare to use a Medicare supplement policy.
Medigap differs from Medicare Advantage. A Medicare Advantage plan is a private plan through which an eligible beneficiary receives Medicare-covered services, usually with plan networks, plan rules, and an annual out-of-pocket maximum. A consumer generally does not use a Medicare supplement policy to supplement a Medicare Advantage plan. Medigap also differs from stand-alone Part D prescription-drug coverage, which is separately arranged for many Original Medicare beneficiaries.
Producers selling Medicare-related products must make accurate comparisons, use required disclosures, and avoid misleading consumers about benefits, provider access, premiums, or enrollment rights. A client's health needs, travel patterns, provider preferences, prescription needs, affordability, and enrollment timing are important factors. No single Medicare arrangement is automatically best for every beneficiary.
References/topics from the Study Guide: Medicare Supplement Insurance; Original Medicare; Medicare Advantage; Medicare Part D; Medicare Cost Sharing.
NEW QUESTION # 89
An insurer shall not issue an individual long-term care insurance contract in Nevada unless the insurer has received from the applicant:
Answer: D
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 # 90
In Nevada, which life insurance policy is subject to a 30-day right to surrender for a premium refund after delivery?
Answer: D
Explanation:
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.
NEW QUESTION # 91
In order for a health insurance producer to be an Exchange Enrollment Facilitator (EEF), the producer:
Answer: D
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 # 92
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