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| Section | Weight | Objectives |
|---|---|---|
| Nevada Statutes, Rules and Regulations | ~32% | - General State Insurance Regulations
|
| Accident and Health — General Knowledge | ~68% | - Types of Health Insurance Policies
|
私たちが提供するNV Accident and Health準備トレントは、精巧にコンパイルされ、非常に効率的です。 InsNV_Health02試験トレントを練習するのに20〜30時間しかかからず、試験に参加できます。仕事などで忙しいほとんどのお客様。ただし、InsNV_Health02テスト準備を使用する場合、短時間で試験を準備して試験内容をマスターするのにそれほど時間は必要ありません。彼らがする必要があるのは、毎日学習して練習するのに1〜2時間を費やし、InsNV_Health02テスト準備で簡単に試験に合格することです。試験に合格するための時間と労力はほとんどかかりません。
質問 # 131
Which of the following statements is correct about the Coordination of Benefits provision?
正解：C
解説：
Coordination of Benefits, commonly called COB, applies when an insured is covered by more than one health plan. It establishes the order in which plans pay and limits the combined payment so the insured does not receive more than the amount of the covered expense. Choice B is correct because COB prevents a profit from duplicate health coverage while still allowing the insured to receive the benefits to which the insured is entitled. One plan is identified as primary and pays first under its policy terms. The secondary plan then considers the unpaid covered balance, subject to its own coordination provisions and limits. COB does not prohibit a person from owning more than one health policy, does not guarantee uninterrupted benefits when changing insurers, and does not authorize a general delay of a workers' compensation claim until benefits expire. Workers' compensation coordination depends on the applicable policy and governing law. On the examination, distinguish COB from nonduplication of benefits and from other insurance clauses; COB specifically allocates payment responsibility among multiple health plans. Study Guide References/Topics:
Group Health Insurance; Coordination of Benefits; Other Insurance Provisions.
質問 # 132
An employee's group life coverage terminates because employment ends. During the applicable conversion period, the former employee dies before applying for an individual policy. What protection does Nevada group-life law provide?
正解：D
解説：
Nevada group-life law protects an insured person during the conversion interval. If a person covered under a group life policy dies during the period in which the person was entitled to obtain an individual conversion policy-and before that individual policy becomes effective-the amount of life insurance the person could have converted is payable as a claim under the group policy. This protection applies whether or not the person submitted the individual-policy application or paid the first premium before death.
The conversion privilege is important because group coverage is usually tied to employment or membership.
When eligibility ends, the individual may lose the group policy's protection. Conversion gives the former insured an opportunity to obtain individual life insurance without new evidence of insurability, subject to the statute and policy terms. The converted amount may be limited by the group policy and applicable law, and the individual policy's premium is based on the insurer's conversion rates.
This rule should not be confused with portability. Portability allows continuation of group-style coverage under certain conditions, whereas conversion replaces group coverage with an individual policy. The producer should explain notice requirements, the available conversion amount, deadlines, and premium differences whenever group coverage terminates.
References/topics from the Study Guide: Group Life Insurance; Conversion Privilege; Termination of Employment; NRS 688B.120-688B.130.
質問 # 133
All insurance companies and producers who sell Group Life or Accident and Health policies in Nevada MUST:
正解：D
解説：
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 .
質問 # 134
In Nevada, a producer or examining physician who knowingly and willfully makes a false statement on an application for insurance may be guilty of:
正解：D
解説：
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 .
質問 # 135
An incorporated licensee who seeks to do business under a fictitious name is required to file a document about the name with the:
正解：B
解説：
An incorporated insurance licensee using a name other than its true legal name must obtain approval and file the required fictitious-name documentation with the Nevada Insurance Commissioner. This ensures that insurance business is conducted under a name that has been reviewed, recorded, and can be connected to the actual licensed person or entity responsible for the transaction. It supports consumer protection, regulatory oversight, complaint handling, and enforcement of licensing laws.
Nevada's producer-licensing law requires an applicant or licensee wishing to use a name other than the true name shown on the license to submit a request for approval and file with the Commissioner a certified copy of the applicable certificate. The purpose is not merely administrative. A producer may not use a trade, assumed, or fictitious name in a way that could conceal the responsible licensee or mislead an insurance consumer.
The Attorney General, NAHU, and NAIFA do not approve fictitious names used by Nevada insurance licensees. The Nevada Division of Insurance, acting through the Commissioner, is the proper regulatory authority.
Study Guide references/topics: Nevada producer licensing; use of true or fictitious names; regulatory authority of the Commissioner; NRS 683A.301 .
質問 # 136
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