Seit Neuem aktualisierte InsNV_Health02 Examfragen für Insurance Licensing InsNV_Health02 Prüfung

Viele der InsNV_Health02 Fragenkatalog NV Accident and Healthaus Zertpruefung sind in der Form von Vielfache-Wahl-Fragen. Um Ihre InsNV_Health02 Zertifizierungsprüfungen reibungslos zu meistern, brauchen Sie nur unsere Insurance Licensing InsNV_Health02 Prüfungsfragen und Antworten (NV Accident and Health) auswendigzulernen.

Insurance Licensing InsNV_Health02 Exam Syllabus Topics:

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

>> InsNV_Health02 Vorbereitungsfragen <<

Insurance Licensing InsNV_Health02 Fragenkatalog & InsNV_Health02 Echte Fragen

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Insurance Licensing NV Accident and Health InsNV_Health02 Prüfungsfragen mit Lösungen (Q102-Q107):

102. Frage
Which of the following statements is generally CORRECT about a major medical policy?

A. It contains more limitations than a Basic Hospital, Medical, or Surgical policy.
B. It provides benefits for reasonable and necessary medical expenses, subject to policy limits.
C. It contains a 30-day Elimination period for losses due to sickness.
D. It provides benefits for in-hospital expenses only, subject to policy limits.

Antwort: B

Begründung:
Major medical insurance is designed to provide broad protection against substantial medical expenses. It commonly covers hospital, surgical, physician, diagnostic, and other medically necessary services, subject to deductibles, coinsurance, exclusions, and stated policy limits. Therefore, choice D is correct. A major medical policy is not limited to in-hospital expenses; that description is more characteristic of basic hospital coverage.
It also is generally broader-not more limited-than a basic hospital, medical, or surgical policy. A 30-day elimination period is associated more closely with disability income insurance and does not define major medical coverage. The phrase "reasonable and necessary" is important because it allows the insurer to evaluate whether a service was medically appropriate and whether the charge falls within the policy's payment standard. Major medical policies are comprehensive, but they are not unlimited: coverage remains subject to deductibles, coinsurance, exclusions, maximum benefits, network terms, and utilization requirements. Study Guide References/Topics: Types of Health Insurance Policies; Major Medical Expense Insurance; Medical Expense Coverage.

103. Frage
Which feature is most characteristic of universal life insurance?

A. Investment risk borne entirely by the insurer in a separate account
B. Coverage that can never build cash value
C. A fixed premium and fixed death benefit with no flexibility
D. Flexible premiums and adjustable death-benefit options, subject to policy requirements

Antwort: D

Begründung:
Universal life insurance is a flexible-premium permanent life insurance policy. It generally provides a cash- value account, interest crediting, mortality charges, expense charges, and flexible premium-payment options within policy limits. The owner may often adjust the amount and timing of premiums and may have death- benefit options, subject to minimum funding requirements, underwriting rules for increases, and the policy's terms. The flexibility does not mean the owner can stop paying indefinitely without consequence. If cash value is insufficient to cover monthly deductions and charges, the policy can lapse.
Universal life differs from traditional whole life, which typically has fixed premiums, a guaranteed cash-value schedule, and a fixed death benefit. It also differs from variable life, in which cash value and death benefit are linked to separate-account investments and market performance. Universal life typically uses the insurer's general account for interest crediting, although variable universal life is a separate product combining flexibility with separate-account investment risk.
A producer must explain that illustrated values are not guaranteed unless identified as such. Policyowners should receive in-force illustrations and review funding adequacy periodically, particularly after taking loans, withdrawals, or reducing premium payments.
References/topics from the Study Guide: Universal Life Insurance; Flexible Premiums; Adjustable Death Benefit; Cash Value; Policy Lapse Risk.

104. Frage
The commission for the placement of nonadmitted insurance is paid by the insurer to the:

A. Division of Insurance
B. policyholder
C. surplus lines broker
D. third-party claimant

Antwort: C

Begründung:
The commission for the placement of nonadmitted insurance is paid to the surplus lines broker. A surplus lines broker is specially licensed to place eligible insurance with a nonadmitted insurer when coverage cannot be procured from authorized insurers under the conditions required by Nevada's Nonadmitted Insurance Law.
A nonadmitted insurer is not licensed or authorized to transact insurance generally in Nevada, but it may provide qualifying surplus-lines coverage through a properly licensed surplus lines broker. The broker performs the regulated placement function, documents the effort to obtain coverage from the admitted market when required, handles applicable filings, and ensures that statutory taxes and disclosures are addressed.
The policyholder purchases the insurance and pays the premium; the policyholder is not paid the placement commission. The Division of Insurance regulates the transaction and may receive taxes, fees, and reports as provided by law, but it is not the recipient of the insurer's commission. A third-party claimant is someone asserting a claim against an insured and has no role in the placement commission.
Study Guide references/topics: nonadmitted insurance; surplus lines; broker licensing; commissions; Nevada Nonadmitted Insurance Law .

105. Frage
Under a group health policy, which of the following coverages MUST be provided for newborn children?

A. Routine eye examinations
B. Congenital health defects
C. Transportation costs from the hospital to the child ' s residence
D. Genetic Testing

Antwort: B

Begründung:
Nevada requires qualifying group health policies that cover family members to provide coverage for a newborn child from the moment of birth. Required newborn coverage includes injury or sickness and specifically includes the necessary care and treatment of medically diagnosed congenital defects and birth abnormalities. Therefore, congenital health defects are the required coverage identified in this question.
The rule is important because congenital defects may be present at birth and can require immediate diagnostic, surgical, medical, or hospital treatment. Nevada law prevents a policy from excluding this necessary care simply because the condition existed at birth. The statute also prohibits exclusion of premature births under the applicable coverage requirement.
The transportation option is incorrect because the law addresses necessary transportation from the place of birth to the nearest specialized treatment center, within policy limits; it does not mandate transportation from the hospital to the child's residence. Routine eye examinations and genetic testing may be covered under a particular policy or health plan, but they are not the specific newborn mandate tested here. Continued coverage beyond the initial period may depend on timely notice and payment of required premium within 31 days.
Study Guide references/topics: group health insurance; newborn coverage; mandated benefits; NRS 689B.033
.

106. Frage
Which underwriting duty is most directly performed by a producer during a life insurance application interview?

A. Gathering complete application information and observing apparent risk factors
B. Determining the insurer's final premium classification
C. Approving all policy loans
D. Paying claims from insurer reserves

Antwort: A

Begründung:
A producer performs field underwriting by gathering complete and accurate application information, explaining questions to the applicant without coaching answers, observing relevant facts, and submitting the application promptly to the insurer. Relevant observations may include obvious health conditions, the applicant's demeanor, financial circumstances, hazardous occupation or avocation information, and whether answers appear complete and consistent. The producer must report material information obtained in the course of the sale rather than deciding independently that an unfavorable fact is unimportant.
The insurer, not the producer, makes the final underwriting decision. The insurer may use the application, medical records, attending-physician statements, inspection reports, prescription-history reports, credit-related information where permitted, and other lawful underwriting tools. Based on that review, the insurer may issue the policy as applied for, issue it with a rating or modification, postpone it, or decline it.
A producer must never alter an applicant's answers, conceal material information, or sign an application for an applicant without authority. Accurate field underwriting protects the applicant, insurer, producer, and beneficiaries by reducing the risk of misrepresentation, rescission, claim disputes, or regulatory action. The producer's role is factual collection and proper submission-not final risk selection.
References/topics from the Study Guide: Field Underwriting; Application Completion; Producer Responsibilities; Insurer Underwriting; Material Facts.

107. Frage
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InsNV_Health02 Fragenkatalog: https://www.zertpruefung.de/InsNV_Health02_exam.html