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Insurance Licensing InsNV_Health02 Exam Syllabus Topics:

SectionWeightObjectives
Nevada Statutes and Codes Common to Life, Health, Property, and Casualty Insurance20%- Insurance Commissioner
  • 1. Notice and hearings and penalties
    • 2. Examinations
      • 3. General powers and duties
        - Definitions
        • 1. Domestic, foreign, and alien
          • 2. Certificate of authority
            • 3. Transacting insurance
              • 4. Premiums
                • 5. Authorized and unauthorized
                  • 6. Cost-sharing
                    • 7. Insurer
                      - Nevada Life and Health Insurance Guaranty Association
                      - Marketing Practices
                      • 1. Required records and record retention
                        • 2. Silver State Health Insurance Exchange
                          • 3. Fiduciary responsibilities
                            • 4. Commissions and payment restrictions
                              • 5. Unfair practices
                                • Unfair claims methods and practices and settlement of claims
                                • Rebating and inducement
                                • Twisting
                                • Misrepresentation
                                • Fraud
                                • Unfair discrimination
                                • Defamation
                              • 6. Affordable Care Act
                                - Licensing
                                • 1. Name of licensee
                                  • 2. Renewal and continuing education
                                    • 3. Suspension, revocation, and refusal of license
                                      • 4. Persons required to be licensed
                                        • 5. Obtaining a license
                                          • 6. Termination of license
                                            Accident & Health โ€“ General Knowledge50%- Social Insurance
                                            • 1. Medicaid
                                              • 2. Medicare Parts A, B, C, and D
                                                • 3. Social Security benefits
                                                  - Types of Policies
                                                  • 1. Accidental death and dismemberment
                                                    • 2. Medicare supplement policies
                                                      • 3. Individual and Group Long Term Care
                                                        • Eligibility
                                                        • Levels of care
                                                      • 4. Other policies
                                                        • Dental
                                                        • Vision
                                                        • Cancer
                                                        • Critical illness or specified disease
                                                        • Worksite employer-sponsored
                                                        • Hospital indemnity
                                                        • Short-term medical
                                                        • Accident
                                                      • 5. 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
                                                      • 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
                                                      - Policy Provisions, Clauses, and Riders
                                                      • 1. Rights of renewability
                                                        • Noncancelable
                                                        • Cancelable
                                                        • Guaranteed renewable
                                                      • 2. Riders
                                                        • Impairment and exclusions
                                                        • Guaranteed insurability
                                                        • Future increase option
                                                      • 3. 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
                                                      • 4. 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
                                                      - Other Insurance Concepts
                                                      • 1. Dependent children benefits
                                                        • 2. Tax treatment of premiums and proceeds of insurance contracts
                                                          • 3. Subrogation
                                                            • 4. Cost containment
                                                              • 5. Occupational vs. non-occupational
                                                                • 6. Primary and contingent beneficiaries
                                                                  • 7. Nonduplication and coordination of benefits
                                                                    • 8. Modes of premium payments
                                                                      • 9. Owner's rights
                                                                        • 10. Total, partial, recurrent, and residual disability
                                                                          • 11. Workers Compensation
                                                                            • 12. Managed care
                                                                              - Field Underwriting Procedures
                                                                              • 1. Submitting application and initial premium to company for underwriting
                                                                                • 2. Initial premium payment and receipt
                                                                                  • 3. Explaining policy provisions, riders, exclusions, and ratings
                                                                                    • 4. Completing the application
                                                                                      • 5. Policy delivery
                                                                                        • 6. Contract law
                                                                                          • Elements of a contract
                                                                                          • Insurable interest
                                                                                          • Warranties and representations
                                                                                          • Unique aspects of the insurance contract
                                                                                        • 7. Replacement
                                                                                          • 8. Sources of insurability and HIPAA privacy information
                                                                                            Nevada Statutes and Codes Pertinent to Health Insurance Only14%- Hospice care
                                                                                            - Coverage for reconstructive surgery
                                                                                            - Availability of coverage for mental health and treatment of alcohol abuse and drug abuse
                                                                                            - Medicare
                                                                                            • 1. Medicare supplement regulation
                                                                                              • 2. Medicare Advantage Plans
                                                                                                • 3. Prescription Drug Plan
                                                                                                  - 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
                                                                                                        - Long Term Care
                                                                                                        Nevada Statutes and Codes Common to Life and Health Insurance Only4%- Credit life and health insurance
                                                                                                        - Advertising
                                                                                                        - Group life and health insurance
                                                                                                        • 1. Required provisions
                                                                                                          • 2. Eligible groups

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                                                                                                            Insurance Licensing NV Accident and Health Sample Questions (Q55-Q60):

                                                                                                            NEW QUESTION # 55
                                                                                                            Which of the following policies provides a specified income benefit when the insured person becomes unable to work because of illness or accident?

                                                                                                            Answer: C

                                                                                                            Explanation:
                                                                                                            Disability Income insurance is designed to replace a portion of an insured's earned income when illness or accidental injury prevents the insured from working. Choice D is correct. Unlike medical expense insurance, which pays for covered health-care costs, disability income coverage pays a stated periodic benefit- commonly monthly-to help the insured meet ordinary financial obligations during disability. Benefits are subject to the policy definition of disability, elimination period, benefit period, maximum monthly benefit, and any offsets or residual-disability provisions. "Emergency Income," "Supplemental Income," and
                                                                                                            "Temporary Income" are not standard policy classifications that describe the core income-replacement product tested here. Disability policies may be written on an own-occupation, modified-own-occupation, or any-occupation basis, and that definition materially affects when benefits are payable. Individual disability income is commonly purchased by self-employed persons, professionals, and others who want income protection beyond employer-sponsored benefits. Group disability plans often provide short-term and long- term benefits, while individual policies can offer more customized benefit levels, riders, and noncancellable or guaranteed-renewable features. Study Guide References/Topics: Types of Health Insurance Policies; Disability Income Insurance; Income Replacement.


                                                                                                            NEW QUESTION # 56
                                                                                                            In Nevada, which life insurance policy is subject to a 30-day right to surrender for a premium refund after delivery?

                                                                                                            Answer: B

                                                                                                            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 # 57
                                                                                                            As a condition to granting a loan, a creditor can:

                                                                                                            Answer: D

                                                                                                            Explanation:
                                                                                                            A creditor may accept an assignment from an existing policy as security for a loan. When consumer credit insurance is required as additional security for debt, Nevada law allows the debtor to furnish the required insurance through existing policies owned or controlled by the debtor, or through any insurer authorized to transact insurance in Nevada.
                                                                                                            A creditor may not require the borrower to purchase insurance from a particular insurer. That would improperly limit the borrower's freedom of choice. The creditor also may not require coverage in an amount greater than the debt being secured. Credit insurance is intended to protect the creditor against the unpaid obligation, not to create excess insurance for the creditor's benefit.
                                                                                                            Similarly, a creditor may not impose a higher interest rate merely because the borrower declines to purchase credit insurance. Credit insurance must not be represented as a mandatory condition of loan approval when it is optional.
                                                                                                            Assignment allows the borrower's existing coverage to be used as collateral or security without forcing the borrower to buy duplicative insurance. The creditor may require proof that the existing insurance is adequate for the risk and debt involved.
                                                                                                            Study Guide references/topics: credit insurance; creditor-debtor relationship; assignment; consumer protections; NRS 690A.140 .


                                                                                                            NEW QUESTION # 58
                                                                                                            Which premium-payment mode usually results in the lowest total annual premium cost for the policyowner?

                                                                                                            Answer: D

                                                                                                            Explanation:
                                                                                                            Annual premium payment generally produces the lowest total cost over the policy year because the insurer receives the full annual premium at the beginning of the coverage period. Monthly, quarterly, and semiannual payment modes are convenient for budgeting, but they commonly include an additional charge or produce a higher total annual premium. The difference reflects the insurer's additional administrative expense and the fact that the insurer receives portions of the premium later.
                                                                                                            Premium mode does not change the policy's face amount, underwriting classification, or contractual benefits.
                                                                                                            It changes only the schedule and total cost of paying the premium. A producer should present all available modes clearly and explain the actual amount due under each option. A consumer with predictable annual cash flow may prefer annual mode to reduce total cost, while a consumer who needs more frequent payments may choose a higher-cost mode to preserve affordability and avoid lapse.
                                                                                                            This issue is distinct from the grace period. The grace period protects the policyowner after a premium due date by allowing a limited time to make payment before coverage lapses. Premium mode establishes how frequently the regular premium is due; it does not eliminate the policyowner's obligation to pay.
                                                                                                            References/topics from the Study Guide: Premium Payment; Premium Modes; Grace Period; Policy Lapse; Life Insurance Contract Provisions.


                                                                                                            NEW QUESTION # 59
                                                                                                            Which policy is designed to pay benefits upon diagnosis or treatment of a specifically named illness, such as cancer?

                                                                                                            Answer: D

                                                                                                            Explanation:
                                                                                                            Specified disease insurance provides limited benefits for a condition or group of conditions specifically named in the policy, such as cancer, heart disease, or stroke. The benefits may be paid as reimbursement for certain covered expenses, as fixed cash amounts for treatment events, or through a schedule of benefits. The scope of coverage is controlled by the policy and is substantially narrower than comprehensive major medical insurance.
                                                                                                            A producer must not represent specified disease coverage as complete health insurance. It may help with deductibles, travel, household costs, experimental-treatment expenses not covered elsewhere, or income disruption, but it is not a substitute for comprehensive coverage that addresses a broad range of illnesses and injuries. The client should understand covered conditions, waiting periods, recurrence provisions, preexisting- condition limitations where permitted, benefit schedules, exclusions, and whether the policy pays in addition to other coverage.
                                                                                                            Major medical insurance is intended to cover a broad spectrum of medically necessary expenses. Credit disability insurance is connected to repayment of a debt if the debtor becomes disabled. Group term life insurance pays a death benefit and does not provide medical-expense coverage. The examination point is to identify the limited, condition-specific purpose of specified disease insurance.
                                                                                                            References/topics from the Study Guide: Specified Disease Insurance; Cancer Insurance; Critical Illness Coverage; Limited-Benefit Health Insurance; Major Medical.


                                                                                                            NEW QUESTION # 60
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                                                                                                            Study Guide InsNV_Health02 Pdf: https://www.pass4leader.com/Insurance-Licensing/InsNV_Health02-exam.html