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| Section | Weight | Objectives |
|---|---|---|
| Nevada Statutes and Codes Pertinent to Health Insurance Only | 14% | - Mandatory policy clauses and provisions
- Availability of coverage for mental health and treatment of alcohol abuse and drug abuse - Hospice care - Long Term Care |
| Nevada Statutes and Codes Common to Life and Health Insurance Only | 4% | - Advertising - Group life and health insurance
|
| Accident & Health – General Knowledge | 50% | - Social Insurance
|
| Nevada Statutes and Codes Common to Life, Health, Property, and Casualty Insurance | 20% | - Marketing Practices
|
>> Insurance Licensing InsNV_Health02 Valid Exam Pdf <<
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NEW QUESTION # 99
In order for a health insurance producer to be an Exchange Enrollment Facilitator (EEF), the producer:
Answer: D
Explanation:
A person may not concurrently hold a Nevada producer license and an Exchange Enrollment Facilitator certificate. Therefore, a health insurance producer who wishes to become an EEF must surrender the producer authority and apply for certification as an Exchange Enrollment Facilitator.
An EEF assists consumers with enrollment in qualified health plans offered through the Exchange. The role is designed to provide objective enrollment help, application assistance, and general information. An EEF may not sell, solicit, or negotiate insurance. The EEF also may not receive consideration from a health insurance issuer or insurer in connection with enrollment and may not receive remuneration arising from EEF activities from a licensed producer, insurance consultant, surplus lines broker, or insurer.
For that reason, a producer cannot receive commissions while acting as an EEF, cannot collect both commission and EEF compensation in the manner described, and cannot steer a consumer toward a particular coverage choice. Producers and EEFs have different legal roles, compensation structures, and consumer- protection limitations.
Study Guide references/topics: Exchange Enrollment Facilitators; producer licensing; prohibited acts; compensation; NRS 695J.210 .
NEW QUESTION # 100
Which statement best describes a group life conversion privilege?
Answer: A
Explanation:
A group life conversion privilege allows an insured whose group coverage terminates to obtain an individual life insurance policy without providing new evidence of insurability, provided the person applies and pays the required premium within the conversion period. The privilege is valuable because a person leaving employment may have become less insurable since original enrollment. Conversion allows continued life coverage despite a change in health, although the individual policy's premium is generally based on the insurer's conversion rates and may be higher than the group rate.
The group master policy and applicable law control the conversion period, maximum conversion amount, and type of individual policy available. The individual policy may not be identical to the group coverage. A producer should explain that the former employee has a limited window to act and should review alternative coverage options promptly.
Conversion differs from portability. Portability allows an insured to continue group-style coverage under certain terms, while conversion results in a new individual policy. The protection during the conversion period is also significant: Nevada group-life law provides a death benefit if the insured dies during the conversion period before the individual policy becomes effective, in the amount that could have been converted.
References/topics from the Study Guide: Group Life Insurance; Conversion Privilege; Portability; Termination of Group Coverage; NRS 688B.120-688B.130.
NEW QUESTION # 101
Which policy is designed to pay benefits upon diagnosis or treatment of a specifically named illness, such as cancer?
Answer: B
Explanation:
Specified disease insurance provides limited benefits for a condition or group of conditions specifically named in the policy, such as cancer, heart disease, or stroke. The benefits may be paid as reimbursement for certain covered expenses, as fixed cash amounts for treatment events, or through a schedule of benefits. The scope of coverage is controlled by the policy and is substantially narrower than comprehensive major medical insurance.
A producer must not represent specified disease coverage as complete health insurance. It may help with deductibles, travel, household costs, experimental-treatment expenses not covered elsewhere, or income disruption, but it is not a substitute for comprehensive coverage that addresses a broad range of illnesses and injuries. The client should understand covered conditions, waiting periods, recurrence provisions, preexisting- condition limitations where permitted, benefit schedules, exclusions, and whether the policy pays in addition to other coverage.
Major medical insurance is intended to cover a broad spectrum of medically necessary expenses. Credit disability insurance is connected to repayment of a debt if the debtor becomes disabled. Group term life insurance pays a death benefit and does not provide medical-expense coverage. The examination point is to identify the limited, condition-specific purpose of specified disease insurance.
References/topics from the Study Guide: Specified Disease Insurance; Cancer Insurance; Critical Illness Coverage; Limited-Benefit Health Insurance; Major Medical.
NEW QUESTION # 102
A group health insurance policy MUST include coverage for which of the following expenses?
Answer: A
Explanation:
A group health insurance policy in Nevada must include coverage for expenses arising from hospice care.
Hospice care is intended for patients with terminal illness and emphasizes comfort, pain control, symptom management, supportive services, and assistance for the patient and family rather than curative treatment.
Nevada's group-policy required-provisions statute specifically identifies benefits for expenses arising from hospice care. This makes hospice the correct answer. Adult dental and adult vision benefits may be offered by separate policies, riders, employer plans, or benefit arrangements, but they are not universally required in every group health policy. Over-the-counter dietary supplements are not a standard mandated group health benefit and are generally covered only when specifically provided by a policy or health plan.
Hospice coverage should be distinguished from ordinary inpatient hospital coverage. Hospice care may be delivered in a home, residential setting, hospice facility, or other appropriate location, depending on the patient's needs and the terms of coverage. It frequently involves an interdisciplinary team and includes both patient care and family-support services.
Study Guide references/topics: group health required provisions; hospice care; mandated benefits; supportive services; NRS 689B.030 .
NEW QUESTION # 103
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?
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 # 104
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