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| Section | Weight | Objectives |
|---|---|---|
| Nevada Statutes, Rules and Regulations | ~32% | - General State Insurance Regulations
|
| Accident and Health — General Knowledge | ~68% | - Policy Provisions, Clauses & Riders
|
>> Insurance Licensing InsNV_Health02 New Dumps Book <<
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NEW QUESTION # 61
Basic cancer plans pay for all of the following EXCEPT:
Answer: B
Explanation:
Basic cancer policies are limited-benefit plans intended to supplement, rather than replace, comprehensive medical coverage. They commonly provide benefits for cancer-specific treatment such as chemotherapy, radiotherapy, and immunotherapy, subject to the policy's definitions, schedules, and limits. Therefore, choice C is correct because physical therapy is not ordinarily a core cancer-treatment benefit under a basic cancer policy. Physical therapy may be covered under a comprehensive medical plan or under a more expansive supplemental policy if expressly included, but it is not a standard basic cancer-plan benefit. Cancer policies can pay specified amounts for surgery, hospital confinement, physician services, diagnostic testing, drugs, radiation, chemotherapy, or other treatment tied directly to a covered cancer diagnosis. The insured should not assume that every medical expense arising during cancer treatment is covered. Benefits may be subject to waiting periods, preexisting-condition restrictions, recurrence rules, benefit schedules, and exclusions. The appropriate exam distinction is between benefits directly associated with treatment of cancer and general rehabilitative or medical services that are not expressly included in the cancer policy. Study Guide References
/Topics: Types of Health Insurance Policies; Limited-Coverage Health Policies; Cancer Insurance.
NEW QUESTION # 62
A Long-Term Care policy provides coverage for:
Answer: A
Explanation:
Long-term care insurance is designed primarily to cover services required when an insured cannot perform activities of daily living independently or has a severe cognitive impairment. Custodial care in a nursing home is a core example of long-term care coverage. Custodial care involves assistance with everyday personal needs, such as bathing, dressing, eating, transferring, toileting, and continence, rather than acute medical treatment.
Long-term care benefits may be provided in a nursing home, assisted-living setting, adult day-care setting, or the insured's home, depending on the policy. Coverage can include skilled nursing care, intermediate care, custodial care, home health care, hospice care, respite care, and care-management services, subject to policy conditions and benefit triggers.
Hospital-expense and medical-expense policies generally focus on acute treatment, physician services, surgery, hospitalization, and related medical costs. Medicare Supplement insurance is designed to help pay certain Medicare deductibles, coinsurance, and copayments; it is not long-term care insurance.
The distinction is crucial: long-term care insurance addresses prolonged assistance and supervision resulting from chronic illness, disability, frailty, or cognitive impairment, whereas major medical insurance focuses principally on acute medical treatment.
Study Guide references/topics: long-term care insurance; custodial care; skilled care; activities of daily living; nursing-home benefits; Nevada long-term-care regulations .
NEW QUESTION # 63
Which of the following BEST describes Medicare Advantage Plans?
Answer: A
Explanation:
Medicare Advantage Plans are best described as government-subsidized private insurance. Medicare Advantage, also called Medicare Part C, is offered by private companies that contract with Medicare and must follow Medicare rules. Eligible beneficiaries receive their Medicare-covered benefits through the private plan instead of receiving benefits through Original Medicare directly.
The federal Medicare program pays private Medicare Advantage organizations to provide covered services to enrolled beneficiaries. The plans must provide all medically necessary services covered by Original Medicare, except hospice care, which remains covered under Original Medicare. Many Medicare Advantage plans also include prescription drug coverage and may provide additional benefits such as dental, vision, hearing, wellness, or transportation benefits.
The plans are private, but they are not privately subsidized government insurance. They are federally regulated Medicare arrangements supported by Medicare payments. They are not long-term care riders and are not welfare benefit plans. Enrollees generally continue paying their Medicare Part B premium and may also pay a plan premium, although some plans have a $0 additional premium.
Study Guide references/topics: Medicare Part C; Medicare Advantage; private insurers; federal Medicare program; Medicare Advantage overview .
NEW QUESTION # 64
An incorporated licensee who seeks to do business under a fictitious name is required to file a document about the name with the:
Answer: A
Explanation:
An incorporated insurance licensee using a name other than its true legal name must obtain approval and file the required fictitious-name documentation with the Nevada Insurance Commissioner. This ensures that insurance business is conducted under a name that has been reviewed, recorded, and can be connected to the actual licensed person or entity responsible for the transaction. It supports consumer protection, regulatory oversight, complaint handling, and enforcement of licensing laws.
Nevada's producer-licensing law requires an applicant or licensee wishing to use a name other than the true name shown on the license to submit a request for approval and file with the Commissioner a certified copy of the applicable certificate. The purpose is not merely administrative. A producer may not use a trade, assumed, or fictitious name in a way that could conceal the responsible licensee or mislead an insurance consumer.
The Attorney General, NAHU, and NAIFA do not approve fictitious names used by Nevada insurance licensees. The Nevada Division of Insurance, acting through the Commissioner, is the proper regulatory authority.
Study Guide references/topics: Nevada producer licensing; use of true or fictitious names; regulatory authority of the Commissioner; NRS 683A.301 .
NEW QUESTION # 65
An employee's group life coverage terminates because employment ends. During the applicable conversion period, the former employee dies before applying for an individual policy. What protection does Nevada group-life law provide?
Answer: B
Explanation:
Nevada group-life law protects an insured person during the conversion interval. If a person covered under a group life policy dies during the period in which the person was entitled to obtain an individual conversion policy-and before that individual policy becomes effective-the amount of life insurance the person could have converted is payable as a claim under the group policy. This protection applies whether or not the person submitted the individual-policy application or paid the first premium before death.
The conversion privilege is important because group coverage is usually tied to employment or membership.
When eligibility ends, the individual may lose the group policy's protection. Conversion gives the former insured an opportunity to obtain individual life insurance without new evidence of insurability, subject to the statute and policy terms. The converted amount may be limited by the group policy and applicable law, and the individual policy's premium is based on the insurer's conversion rates.
This rule should not be confused with portability. Portability allows continuation of group-style coverage under certain conditions, whereas conversion replaces group coverage with an individual policy. The producer should explain notice requirements, the available conversion amount, deadlines, and premium differences whenever group coverage terminates.
References/topics from the Study Guide: Group Life Insurance; Conversion Privilege; Termination of Employment; NRS 688B.120-688B.130.
NEW QUESTION # 66
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