Top InsNV_Health02 Questions | InsNV_Health02 New Study Materials

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Insurance Licensing InsNV_Health02 Exam Syllabus Topics:

Section	Weight	Objectives
Nevada Statutes and Codes Common to Life and Health Insurance Only	4%	- Group life and health insurance 1. Eligible groups 2. Required provisions - Advertising - Credit life and health insurance
Nevada Statutes and Codes Common to Life, Health, Property, and Casualty Insurance	20%	- Marketing Practices 1. Affordable Care Act 2. Silver State Health Insurance Exchange 3. Fiduciary responsibilities 4. Unfair practices Unfair claims methods and practices and settlement of claims Rebating and inducement Twisting Misrepresentation Fraud Unfair discrimination Defamation 5. Commissions and payment restrictions 6. Required records and record retention - Definitions 1. Certificate of authority 2. Transacting insurance 3. Domestic, foreign, and alien 4. Insurer 5. Premiums 6. Authorized and unauthorized 7. Cost-sharing - Licensing 1. Obtaining a license 2. Name of licensee 3. Renewal and continuing education 4. Termination of license 5. Persons required to be licensed 6. Suspension, revocation, and refusal of license - Nevada Life and Health Insurance Guaranty Association - Insurance Commissioner 1. General powers and duties 2. Examinations 3. Notice and hearings and penalties
Nevada Statutes and Codes Pertinent to Health Insurance Only	14%	- Mandatory policy clauses and provisions 1. Coverage for physical handicap or intellectual disability for dependent children 2. Coverage for preventive healthcare services 3. Coverage for newborn children - Long Term Care - Medicare 1. Prescription Drug Plan 2. Medicare Advantage Plans 3. Medicare supplement regulation - Availability of coverage for mental health and treatment of alcohol abuse and drug abuse - Coverage for reconstructive surgery - Hospice care
Accident & Health – General Knowledge	50%	- Other Insurance Concepts 1. Managed care 2. Tax treatment of premiums and proceeds of insurance contracts 3. Cost containment 4. Workers Compensation 5. Occupational vs. non-occupational 6. Subrogation 7. Modes of premium payments 8. Primary and contingent beneficiaries 9. Nonduplication and coordination of benefits 10. Owner's rights 11. Dependent children benefits 12. Total, partial, recurrent, and residual disability - Field Underwriting Procedures 1. Contract law Elements of a contract Insurable interest Warranties and representations Unique aspects of the insurance contract 2. Initial premium payment and receipt 3. Replacement 4. Submitting application and initial premium to company for underwriting 5. Completing the application 6. Sources of insurability and HIPAA privacy information 7. Explaining policy provisions, riders, exclusions, and ratings 8. Policy delivery - Policy Provisions, Clauses, and Riders 1. 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 2. Rights of renewability Noncancelable Cancelable Guaranteed renewable 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. Riders Impairment and exclusions Guaranteed insurability Future increase option - Social Insurance 1. Medicare Parts A, B, C, and D 2. Social Security benefits 3. Medicaid - Types of Policies 1. Medicare supplement policies 2. Other policies Dental Vision Cancer Critical illness or specified disease Worksite employer-sponsored Hospital indemnity Short-term medical Accident 3. Accidental death and dismemberment 4. Group insurance Differences between individual and group contracts General characteristics COBRA 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. Individual and Group Long Term Care Eligibility Levels of care 7. Disability income Individual disability income policy Business overhead expense policy Business disability buyout policy Group disability income policy Key employee policy

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Insurance Licensing NV Accident and Health Sample Questions (Q76-Q81):

NEW QUESTION # 76
What is the primary purpose of a waiver-of-premium rider on a life insurance policy?

A. It guarantees a higher death benefit every year.
B. It converts term insurance automatically into whole life insurance.
C. It eliminates all future policy loans.
D. It waives required premiums if the insured becomes totally disabled as defined by the rider.

Answer: D

Explanation:
A waiver-of-premium rider keeps qualifying life insurance coverage in force by waiving required premiums when the insured becomes totally disabled as defined in the rider. The rider protects against the risk that disability will interrupt income and make premium payments unaffordable. Once the rider's requirements are satisfied, the insurer pays or waives the premium according to the policy terms, allowing the coverage and any applicable cash-value features to continue.
The definition of total disability, the waiting period, the age limitation, proof-of-disability requirements, and the duration of the waiver are contractual matters. The rider does not usually mean that premiums are waived for every illness, injury, or temporary work interruption. The insured must meet the stated definition and provide required evidence. Some riders also require that disability begin before a specified age.
This rider should not be confused with disability-income insurance. Disability income pays a periodic benefit to replace a portion of income. Waiver of premium does not provide an income payment; it protects the life policy from lapse due to qualifying disability. It also differs from a payor-benefit rider, which is commonly used with juvenile policies and protects the policy when the premium-paying adult dies or becomes disabled.
References/topics from the Study Guide: Waiver of Premium Rider; Total Disability; Disability Income; Payor Benefit Rider; Policy Continuation.

NEW QUESTION # 77
Under a Disability policy, the Elimination period is:

A. the same as a Probationary period
B. predetermined by the insurance company
C. usually longer for accidents than for sickness
D. similar to a deductible but expressed in terms of time rather than dollars

Answer: D

Explanation:
The elimination period is the waiting period that must pass after disability begins before disability income benefits become payable. Choice C is correct because it performs a function similar to a deductible, but it is measured in time rather than dollars. For example, a policy may require an insured to remain disabled for 30,
60, 90, or 180 days before benefits begin. The insured bears the financial impact of the disability during that initial period, just as an insured bears a deductible before medical expense benefits apply. A longer elimination period generally reduces the policy premium because the insurer begins payments later and may avoid paying shorter-duration claims. The elimination period is not necessarily longer for accidents than sickness; many policies use the same waiting period for both. It is selected under the policy terms, rather than being an undefined period solely controlled by the insurer. It is also not the same as a probationary period, which is a period at the beginning of a policy during which sickness losses may be excluded. Study Guide References/Topics: Policy Provisions, Clauses, and Riders; Disability Income Insurance; Elimination Period.

NEW QUESTION # 78
When a nonqualified annuity is surrendered for more than the owner's investment in the contract, how is the gain generally treated for federal income-tax purposes?

A. As ordinary income
B. As a tax-free return of principal only
C. As a long-term capital gain in all cases
D. As a deductible business loss

Answer: A

Explanation:
Gain from a nonqualified annuity is generally taxed as ordinary income when distributed. The owner's investment in the contract, often called the cost basis, is not taxed again because it was paid with after-tax dollars. However, the growth above that basis is tax-deferred only while it remains inside the annuity. When the owner surrenders the contract or receives a taxable distribution, the gain is subject to ordinary-income treatment rather than the preferential capital-gains treatment that may apply to certain investments.
A nonqualified annuity is funded with after-tax money and is not held inside a qualified retirement arrangement such as an IRA or employer plan. The contract's tax deferral can be valuable for long-term planning, but it does not mean that every distribution is tax free. In addition, distributions before age 59½ may be subject to an additional federal tax penalty unless an exception applies. A full surrender may also trigger a surrender charge under the contract if it occurs during the surrender-charge period.
The producer should never present an annuity as tax avoidance. The accurate explanation is tax deferral, possible ordinary-income taxation of gain upon distribution, potential penalties for early distributions, and the importance of consulting a qualified tax adviser for individual circumstances.
References/topics from the Study Guide: Annuity Taxation; Nonqualified Annuities; Cost Basis; Tax Deferral; Surrender Charges.

NEW QUESTION # 79
An applicant unintentionally gives an incorrect answer about a material health condition on a life insurance application. This is best described as:

A. A warranty that automatically voids the policy
B. A premium-payment mode
C. A representation that may be material to underwriting
D. A rider

Answer: C

Explanation:
An application statement is generally a representation rather than a warranty. A representation is a statement believed to be true to the best of the applicant's knowledge and belief. If a representation is false and material to the insurer's underwriting decision, it may create a basis for the insurer to investigate, contest, rescind, or adjust the policy according to applicable law and the policy's contestability provision. Materiality means the information would have influenced the insurer's decision to issue the policy, set the premium, determine the rating class, or limit coverage.
A warranty is a statement or promise that must be literally true or strictly complied with. Life and health insurance applications are not ordinarily treated as a collection of warranties because that result would be excessively harsh for innocent or immaterial errors. Nevada life insurance law states that, absent fraud, statements in an attached application are deemed representations rather than warranties.
Intent matters in distinguishing an innocent mistake from intentional fraud, but an unintentional error can still be material. Producers should read each question clearly, ensure the applicant understands it, record answers accurately, and allow the applicant to review the completed application before signing. The producer should never suggest that a medical condition, medication, or prior treatment can be omitted.
References/topics from the Study Guide: Representations and Warranties; Material Misrepresentation; Application Statements; Fraud; NRS 688A.070.

NEW QUESTION # 80
Group coverage for a handicapped dependent child may be continued if the primary insured submits the required proof to the insurance company within what MAXIMUM period of time after the child reaches the limiting age?

A. 45 days
B. 30 days
C. 15 days
D. 31 days

Answer: D

NEW QUESTION # 81
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