Reliable Insurance Licensing InsNV_Health02 Exam Topics, Reliable InsNV_Health02 Test Guide

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Insurance Licensing InsNV_Health02 Exam Syllabus Topics:

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

>> Reliable Insurance Licensing InsNV_Health02 Exam Topics <<

Reliable InsNV_Health02 Test Guide - Authorized InsNV_Health02 Test Dumps

The Insurance Licensing InsNV_Health02 practice questions come with three easy-to-use and install formats. The certification for the Insurance Licensing InsNV_Health02 exam is a valuable, well-recognized professional credential. You can develop your skills and become a recognized specialist with the NV Accident and Health InsNV_Health02 Certification in addition to learning about new technology requirements.

Insurance Licensing NV Accident and Health Sample Questions (Q63-Q68):

NEW QUESTION # 63
Which of the following is NOT a preventive benefit for adults?

A. High blood pressure screening
B. Mammograms
C. Skin cancer screening
D. Physical therapy

Answer: C

Explanation:
Skin cancer screening is the correct answer because it is not included as a broadly required preventive benefit for adults in the same manner as the other listed services. Preventive-service requirements are tied to specified recommended services and may vary by population, risk status, and recommendation level. A service may be medically useful or covered by a particular policy without being a universally required no-cost preventive benefit.
High blood pressure screening is a standard adult preventive screening. Mammography is a recognized preventive screening benefit for eligible women. Physical therapy can be included in preventive fall- intervention services for certain adults, particularly older adults at risk of falls, when the preventive-service criteria are met. Thus, the question is testing the distinction between services commonly covered in some circumstances and services specifically identified as preventive benefits.
Skin examinations or skin cancer evaluations may be medically necessary when a lesion, symptom, prior diagnosis, or risk factor is present. In that circumstance, the service may be classified as diagnostic rather than preventive and can be subject to policy terms and cost sharing.
For examination purposes, remember that preventive-benefit questions focus on the mandated screening list and preventive-care criteria, not merely on whether a service can be medically valuable.
Study Guide references/topics: preventive care; adult screenings; in-network preventive benefits; adult preventive-care benefits .

NEW QUESTION # 64
All insurance companies and producers who sell Group Life or Accident and Health policies in Nevada MUST:

A. notify the Commissioner when individual certificates have been issued
B. deliver a policy to each insured member of a group
C. obtain a receipt when delivering individual certificates to insureds
D. deliver to the policyholder individual certificates for all insureds

Answer: D

Explanation:
Group insurance is generally issued through a master policy. The policyholder-often an employer, association, trustee, or creditor-receives the master contract. Individual insured members do not receive a separate master policy; instead, they receive certificates describing the coverage, benefits, limitations, and applicable rights.
Nevada requires companies, resident agents, and nonresident agents or brokers conducting group life or group accident and health business to provide for delivery of the required individual certificates to the policyholder.
They must also use their best efforts to ensure that the policyholder distributes the certificates to covered debtors, members, or employees. Accordingly, option B correctly states the required delivery process.
Option C is incorrect because each group member is not entitled to receive the full group policy. Option A adds a receipt requirement that is not the applicable rule. Option D is also incorrect because the regulation does not require notice to the Commissioner each time certificates are issued.
This requirement ensures that insured individuals receive understandable evidence of their group coverage even though the policyholder owns the master policy. Certificates are central to informing members of benefits, exclusions, and conversion rights.
Study Guide references/topics: group life insurance; group accident and health insurance; certificates of coverage; NAC 687B.405 .

NEW QUESTION # 65
Under a Disability policy, the Elimination period is:

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

Answer: A

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 # 66
Under an individual health policy issued in Nevada, a newborn is automatically covered for a MAXIMUM of how many days after birth?

A. Five
B. Two
C. Thirty-one
D. Ten

Answer: C

Explanation:
A newborn is automatically covered under the applicable Nevada health-policy rule for 31 days after birth.
Coverage begins from the moment of birth and includes necessary care and treatment for injury or sickness, including medically diagnosed congenital defects and birth abnormalities.
To continue coverage beyond the initial 31-day period, the policy may require timely notice of the birth and payment of any additional premium or fee required by the insurer. The notification and payment requirement must be satisfied within the 31-day period if the policy requires it. This rule protects newborns during the immediate post-birth period, when medical care may be urgently necessary.
The automatic coverage is not limited to routine newborn care. It includes necessary treatment of medical conditions identified at birth, subject to the policy's applicable limits. The law also prevents the policy from excluding premature births under the mandated newborn coverage.
Two, five, and ten days are incorrect because they would not provide the statutory protection required for newborn coverage. The exam point is that the initial automatic period is 31 days, while continuation beyond that period may require prompt enrollment action by the insured.
Study Guide references/topics: individual health insurance; newborn coverage; congenital defects; notification requirements; Nevada newborn-coverage requirements .

NEW QUESTION # 67
In Nevada, a producer or examining physician who knowingly and willfully makes a false statement on an application for insurance may be guilty of:

A. fraud
B. twisting
C. coercion
D. misrepresentation

Answer: A

Explanation:
A producer, examining physician, applicant, or other person who knowingly and willfully makes a false or fraudulent statement or representation in, or in reference to, an insurance application may be guilty of fraud.
Nevada law expressly prohibits this conduct because insurance underwriting depends on truthful and complete information concerning the proposed insured and the risk.
Fraud requires knowing and willful conduct. An innocent clerical error or an inadvertent misunderstanding may require correction, but the exam question describes intentional falsification. Examples can include knowingly misstating medical history, concealing material treatment, falsifying income information in a disability application, or knowingly submitting an untrue medical statement.
Twisting is an improper sales practice involving inducing a policyowner to replace coverage through misleading comparisons or representations. Misrepresentation is a broader term that may describe false statements in insurance transactions, but the statute specifically identifies false or fraudulent application statements as insurance fraud. Coercion involves forcing or improperly pressuring a person to act and is not the conduct described here.
A producer must ensure that application answers are accurately recorded, should not alter answers without authorization, and should promptly correct discovered inaccuracies before policy issuance.
Study Guide references/topics: insurance fraud; applications; producer ethics; prohibited trade practices; NRS
686A.290 .

NEW QUESTION # 68
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