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Insurance Licensing InsNV_Health02 Exam Syllabus Topics:

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

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Insurance Licensing NV Accident and Health Sample Questions (Q56-Q61):

NEW QUESTION # 56
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?

A. The deceased child's descendants receive that child's share.
B. The deceased child's share passes to the insurer.
C. The surviving child receives all proceeds.
D. The estate of the deceased child automatically receives all proceeds.

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 # 57
A long-term-care policy commonly becomes eligible to pay benefits when the insured is certified as chronically ill because the insured:

A. Has missed one premium payment
B. Cannot perform at least two activities of daily living without substantial assistance
C. Has reached age 65
D. Is unemployed for 30 days

Answer: B

Explanation:
Long-term-care insurance commonly uses functional and cognitive triggers to determine benefit eligibility. A typical trigger is certification that the insured cannot perform at least two activities of daily living, or ADLs, without substantial assistance for the required period. Common ADLs include bathing, continence, dressing, eating, toileting, and transferring. Another common trigger is severe cognitive impairment requiring substantial supervision to protect the insured's health and safety.
Long-term-care coverage is not based merely on reaching a certain age, unemployment, or a premium- payment issue. It is designed to help pay for qualifying long-term services when the insured needs ongoing assistance because of chronic illness, disability, or cognitive impairment. Covered services may include nursing-home care, assisted living, adult day care, home health care, hospice care, and respite care, depending on the policy.
The producer should explain the elimination period, daily or monthly benefit limit, benefit period, inflation- protection options, facility restrictions, and policy exclusions. An insured may need care for years, so a policy with a low daily benefit or short benefit period may not meet the client's needs. Suitability requires evaluating likely care preferences, assets, family support, and affordability.
References/topics from the Study Guide: Long-Term Care Insurance; Activities of Daily Living; Cognitive Impairment; Benefit Triggers; Elimination Period.

NEW QUESTION # 58
Insurance for the primary purpose of repaying a loan in the event of disability is referred to as:

A. Credit Accident and Health policy
B. Loan Repayment policy
C. Guaranteed Asset Protection policy
D. Credit Life and Major Medical policy

Answer: A

Explanation:
Credit Accident and Health insurance is insurance on a debtor that provides indemnity for payments or debt becoming due on a specific loan or credit transaction while the debtor is disabled as defined by the policy. Its primary purpose is to protect the borrower and creditor by helping repay the outstanding debt when disability prevents the borrower from working or making scheduled payments.
The coverage may pay periodic loan installments during a qualifying disability or, depending on policy design, provide benefits related to the unpaid debt. It is connected to a specific credit obligation rather than serving as broad disability-income protection. The benefit is limited by the loan terms, policy provisions, waiting period, disability definition, and maximum benefit duration.
Guaranteed Asset Protection, or GAP, generally addresses the difference between an automobile's outstanding loan balance and its actual cash value after a covered total loss. Credit life insurance pays or reduces debt upon the debtor's death, not disability. "Loan Repayment policy" is not the standard statutory insurance term.
The examination distinction is that disability-related loan protection is Credit Accident and Health insurance, while death-related loan protection is Credit Life insurance.
Study Guide references/topics: credit insurance; disability protection; credit accident and health insurance; debtor; NRS 690A.0135 .

NEW QUESTION # 59
Nevada insurance laws define a domestic insurance company as one formed under the laws of:

A. the state of Nevada only
B. the state of Nevada as well as any of its neighboring states
C. any jurisdiction of the United States of America
D. any territory of the United States of America

Answer: A

Explanation:
A domestic insurer in Nevada is an insurer formed under the laws of Nevada, unless it has converted to foreign-insurer status. Therefore, "the state of Nevada only" is the correct answer.
The terms domestic, foreign, and alien describe the jurisdiction in which an insurer is formed or domiciled; they do not describe the insurer's size, financial condition, or whether it is authorized to do business in Nevada. A foreign insurer is formed under the laws of another jurisdiction, generally another U.S. state, but may be authorized to transact insurance in Nevada. An alien insurer is formed under the laws of a country other than the United States.
An insurer may be domestic in one state and foreign in every other state. For example, an insurer incorporated under Nevada law is domestic in Nevada but foreign in California, Arizona, or any other state. Conversely, a company formed in another state is foreign in Nevada even if it holds a Nevada certificate of authority.
Study Guide references/topics: domestic insurers; foreign insurers; alien insurers; insurer domicile; NRS
679A.090 .

NEW QUESTION # 60
A corporation purchases life insurance on a highly valuable executive and is named as owner, premium payer, and beneficiary. What is the primary purpose of this arrangement?

A. Viatical settlement insurance
B. Family maintenance insurance
C. Key person insurance
D. Credit life insurance

Answer: C

Explanation:
Key person insurance is life insurance purchased by a business on the life of an employee, owner, executive, or specialist whose death would create a significant financial loss for the business. The business is generally the owner, premium payer, and beneficiary. If the key person dies, the death proceeds can help the business offset lost revenue, recruit and train a replacement, protect credit relationships, reassure customers, or meet other financial obligations during the transition.
The key person must consent to the insurance, and the business must have a legitimate insurable interest at the time coverage is issued. Key person insurance is not designed to provide personal family protection to the employee. It protects the business against the financial consequences of losing an important contributor.
Credit life insurance is designed to help pay an outstanding debt upon the debtor's death. Family maintenance insurance is generally personal coverage intended to replace income or support dependents. A viatical settlement involves the sale of an existing life insurance policy to a third party, typically when the insured has a serious illness.
The producer should conduct a financial-needs analysis and coordinate with legal and tax advisers because ownership, consent, accounting treatment, and tax consequences require careful planning.
References/topics from the Study Guide: Key Person Insurance; Business Uses of Life Insurance; Insurable Interest; Business Continuation Planning; Executive Protection.

NEW QUESTION # 61
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