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| Section | Weight | Objectives |
|---|---|---|
| Topic 1: Nevada Statutes and Codes Common to Life, Health, Property, and Casualty Insurance | 20% | - Nevada Life and Health Insurance Guaranty Association - Insurance Commissioner
|
| Topic 2: Nevada Statutes and Codes Common to Life and Health Insurance Only | 4% | - Advertising - Group life and health insurance
|
| Topic 3: Accident & Health – General Knowledge | 50% | - Types of Policies
|
| Topic 4: Nevada Statutes and Codes Pertinent to Health Insurance Only | 14% | - Mandatory policy clauses and provisions
- Hospice care - Availability of coverage for mental health and treatment of alcohol abuse and drug abuse - Medicare
|
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NEW QUESTION # 71
A life insurance policy owner has paid $1,200 in premiums in six months for a $250,000 policy. The policyowner dies suddenly and the insurer pays the beneficiary $250,000. This exchange of unequal values reflects which of the following insurance contract features?
Answer: D
Explanation:
An insurance contract is aleatory because the values exchanged by the parties may be unequal and depend on an uncertain event. Choice A is correct. In this example, the policyowner paid only $1,200 in premiums before death, while the insurer paid a $250,000 death benefit. The insurer's obligation was much greater than the premium amount received because the insured event occurred early in the policy period. If death had not occurred for many years, the total premiums paid could have been much closer to or greater than the eventual benefit value. That uncertainty is the defining aleatory feature. A personal contract is based on the insured's individual characteristics and insurable interest. A unilateral contract means only the insurer makes a legally enforceable promise to perform after the applicant accepts the contract and pays premium. A conditional contract requires stated conditions, such as premium payment and proof of loss, to be met before performance is due. None of those terms focuses on the unequal exchange demonstrated here. Study Guide References
/Topics: Policy Provisions, Clauses, and Riders; Insurance Contract Characteristics; Aleatory Contracts.
NEW QUESTION # 72
In a contributory group health insurance plan, which statement is correct?
Answer: B
Explanation:
A contributory group health plan is one in which covered employees pay a portion of the premium. Because employees must elect coverage and contribute financially, insurers commonly require a minimum percentage of eligible employees to participate. The participation requirement reduces adverse selection by helping ensure that enrollment includes a broad cross-section of the eligible group rather than only individuals who expect immediate medical expenses.
A noncontributory plan is one in which the employer pays the full premium for eligible employees. Because employees are not required to contribute, participation is generally expected to be much higher and may be mandatory for eligible employees under the employer's plan rules. The distinction is based on premium contribution, not on whether the coverage includes dependents, dental benefits, or a network.
Group insurance is characterized by a master policy issued to the policyholder, commonly an employer or association. Individual insureds receive certificates of coverage that describe the benefits and rights under the group contract. The employer's role, employee eligibility rules, waiting periods, and contribution structure must all be disclosed accurately.
On an examination question, remember the primary rule: contributory means employees contribute toward premium; noncontributory means the employer pays the entire premium for the covered employees.
References/topics from the Study Guide: Group Health Insurance; Contributory Plans; Noncontributory Plans; Participation Requirements; Certificates of Coverage.
NEW QUESTION # 73
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 # 74
A life policy lapses because a premium was not paid. To reinstate the policy, the insurer will generally require all of the following EXCEPT:
Answer: A
Explanation:
Reinstatement restores a lapsed life insurance policy to active status if the policyowner satisfies the policy's requirements. Those requirements generally include applying for reinstatement within the permitted period, providing evidence of insurability satisfactory to the insurer, and paying overdue premiums plus interest. The exact reinstatement period and underwriting requirements are controlled by the policy and applicable law.
A new medical examination is not required in every case. The insurer may request medical information or an examination when needed to evaluate the applicant's current insurability, but it is not an automatic universal requirement. The key examination principle is that evidence of insurability is required, not that a physical examination must always occur. Reinstatement is often preferable to purchasing a new policy because the existing policy may have more favorable premium rates, accumulated cash value, or a prior issue age.
However, the policyowner must understand that contestability and certain exclusions may begin again with respect to the reinstatement.
A producer should explain the difference between reinstatement and renewal. Reinstatement restores a policy that lapsed; renewal continues or extends a policy under its existing terms. Neither should be assumed available without reviewing the contract.
References/topics from the Study Guide: Reinstatement Provision; Policy Lapse; Evidence of Insurability; Premium Payment; NRS 688A.130.
NEW QUESTION # 75
A policyowner names two children as beneficiaries "per stirpes." If one child dies before the insured but leaves children, how are that deceased child's share and the surviving child's share handled?
Answer: A
Explanation:
A per stirpes beneficiary designation means "by the branch" or "by the bloodline." If a named beneficiary dies before the insured, that beneficiary's descendants take the deceased beneficiary's share. In this question, the deceased child's children receive the share that would have gone to their parent, while the surviving child receives that child's own share. This preserves each family branch's intended portion of the life insurance proceeds.
A per capita designation works differently. Under a per capita arrangement, surviving members of a named class generally share equally, and a deceased beneficiary's descendants do not automatically take the deceased beneficiary's share unless the designation or policy language provides otherwise. The precise result always depends on the policy designation, applicable law, and any contingent- beneficiary provisions.
Beneficiary designations should be reviewed after divorce, marriage, birth, death, adoption, or other major changes. A producer should not provide legal advice about estate planning, but should encourage the policyowner to obtain professional legal guidance when the designation involves trusts, minors, estates, complex family arrangements, or special-needs planning.
The test point is straightforward: per stirpes preserves the deceased beneficiary's branch; per capita distributes among the surviving members of the class.
References/topics from the Study Guide: Beneficiary Designations; Per Stirpes; Per Capita; Primary and Contingent Beneficiaries; Estate Planning Basics.
NEW QUESTION # 76
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