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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 - Licensing
|
| Topic 2: 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 - Medicare
- Mandatory policy clauses and provisions
|
| Topic 3: Nevada Statutes and Codes Common to Life and Health Insurance Only | 4% | - Credit life and health insurance - Group life and health insurance
|
| Topic 4: Accident & Health – General Knowledge | 50% | - Social Insurance
|
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NEW QUESTION # 44
Which of the following information is included in the Consideration clause in an Accident and Health policy?
Answer: A
Explanation:
The consideration clause identifies the exchange of value that creates the insurance contract. The insurer's consideration is its promise to provide the stated coverage and pay covered claims. The applicant's consideration consists of the application statements and payment of the required premium. Therefore, choice D is correct because the policy identifies the schedule and amount of premium payments as part of that contractual consideration. The coverage description is found in the insuring clause and benefit provisions.
Contestability is addressed in the time-limit or incontestability provisions. The grace period is stated in a separate mandatory policy provision dealing with late premium payments and continuation of coverage. The consideration clause is important because it establishes that insurance is a reciprocal exchange: the insurer assumes risk in return for the applicant's premium and representations. If the premium is not paid as required, the policy can lapse after the grace period unless another provision applies. The clause also connects the policy and attached application as part of the entire contract, subject to applicable individual accident and health insurance requirements. Study Guide References/Topics: Policy Provisions, Clauses, and Riders; Consideration Clause; Entire Contract.
NEW QUESTION # 45
The Nevada Life and Health Insurance Guaranty Association is financed by which of the following methods?
Answer: D
Explanation:
The Nevada Life and Health Insurance Guaranty Association is financed through assessments on member insurance companies. Insurers authorized to transact covered life, health, or annuity business in Nevada are members of the Association as a condition of their authority to operate in the state. When an assessment is necessary, the Association assesses member insurers according to the statutory assessment system.
The Association exists to provide limited protection when a member insurer becomes impaired or insolvent and cannot meet covered contractual obligations. It is not financed by direct assessments against insureds, policyowners, agents, or association members. It is also not simply funded through a general premium tax imposed on consumers.
Nevada law establishes assessment classes, including assessments for administrative and legal expenses and assessments needed to carry out the Association's obligations regarding an impaired or insolvent insurer.
Member insurers may consider the cost of assessments when establishing rates and dividends, but that does not change the source of the Association's direct funding: the member insurers themselves.
The Guaranty Association is a safety mechanism with statutory limits. It is not a substitute for evaluating an insurer's financial strength, and insurers and producers may not use its existence as a sales inducement.
Study Guide references/topics: insurer insolvency; guaranty associations; member insurer assessments; NRS Chapter 686C .
NEW QUESTION # 46
In a variable annuity, who bears the investment risk associated with the separate-account investment performance?
Answer: A
Explanation:
In a variable annuity, the contract owner bears the investment risk because contract values are tied to the performance of selected investment options held in a separate account. If those investments perform well, the accumulation value may increase. If they decline, the account value may decrease. The insurer does not guarantee a fixed return on the separate-account portion of the contract, although the contract may include certain insurance guarantees, such as a death-benefit feature or optional living benefits.
This is the central distinction between fixed and variable annuities. A fixed annuity generally credits interest at a guaranteed minimum rate and may declare additional interest under the contract terms. The insurer bears the investment risk for its general account. A variable annuity offers market-based investment choices and transfers market risk to the owner. Because variable annuity values are securities-linked, the producer must also satisfy applicable securities-registration and licensing requirements in addition to life insurance authority.
The suitability analysis is important. Variable annuities may be appropriate for a consumer seeking long-term growth potential who understands market volatility and has an appropriate time horizon. They are not automatically appropriate for a person who requires principal stability, liquidity, or predictable fixed returns.
References/topics from the Study Guide: Fixed Annuities; Variable Annuities; Separate Accounts; General Accounts; Investment Risk; Suitability.
NEW QUESTION # 47
Which of the following is NOT a preventive benefit for adults?
Answer: D
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 # 48
Under a life insurance policy with a revocable beneficiary designation, who normally has the authority to change the beneficiary?
Answer: D
Explanation:
The policyowner normally holds the contractual rights known as incidents of ownership. When the beneficiary designation is revocable, the policyowner may generally change the beneficiary without obtaining that beneficiary's consent, provided the policy is in force and no assignment or court order restricts the right.
The owner may also ordinarily exercise other ownership rights, such as selecting premium-payment modes, assigning the policy, taking a policy loan when available, surrendering the policy for cash value, and electing settlement options.
The insured and the owner can be the same person, but they do not have to be. The insured is the person whose life is covered and whose death triggers payment of the death benefit. A beneficiary is the person or entity designated to receive policy proceeds. Those roles must be kept separate on examination questions. A revocable beneficiary has only an expectancy until the insured dies; by contrast, an irrevocable beneficiary usually has a vested interest that limits the owner's ability to change the designation or exercise certain policy rights without consent.
Correctly identifying the owner is essential because ownership determines control of the policy during the insured's lifetime.
References/topics from the Study Guide: Policyowners' Rights; Beneficiary Designations; Revocable and Irrevocable Beneficiaries; Assignments.
NEW QUESTION # 49
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