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| Section | Weight | Objectives |
|---|---|---|
| Accident & Health – General Knowledge | 50% | - Policy Provisions, Clauses, and Riders
|
| Nevada Statutes and Codes Common to Life, Health, Property, and Casualty Insurance | 20% | - Nevada Life and Health Insurance Guaranty Association - Definitions
|
| Nevada Statutes and Codes Pertinent to Health Insurance Only | 14% | - Medicare
- Coverage for reconstructive surgery - Long Term Care - Hospice care |
| Nevada Statutes and Codes Common to Life and Health Insurance Only | 4% | - Group life and health insurance
- Credit life and health insurance |
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58. Frage
As a condition to granting a loan, a creditor can:
Antwort: A
Begründung:
A creditor may accept an assignment from an existing policy as security for a loan. When consumer credit insurance is required as additional security for debt, Nevada law allows the debtor to furnish the required insurance through existing policies owned or controlled by the debtor, or through any insurer authorized to transact insurance in Nevada.
A creditor may not require the borrower to purchase insurance from a particular insurer. That would improperly limit the borrower's freedom of choice. The creditor also may not require coverage in an amount greater than the debt being secured. Credit insurance is intended to protect the creditor against the unpaid obligation, not to create excess insurance for the creditor's benefit.
Similarly, a creditor may not impose a higher interest rate merely because the borrower declines to purchase credit insurance. Credit insurance must not be represented as a mandatory condition of loan approval when it is optional.
Assignment allows the borrower's existing coverage to be used as collateral or security without forcing the borrower to buy duplicative insurance. The creditor may require proof that the existing insurance is adequate for the risk and debt involved.
Study Guide references/topics: credit insurance; creditor-debtor relationship; assignment; consumer protections; NRS 690A.140 .
59. Frage
Which statement is true of a variable life insurance policy?
Antwort: C
Begründung:
Variable life insurance is permanent life insurance with cash values invested in separate-account investment options. Because the value of those investments can rise or fall, the policyowner bears the investment risk.
The policy's cash value may fluctuate based on market performance, and the death benefit may vary above a guaranteed minimum amount, subject to policy provisions. The insurer does not guarantee the investment performance of the separate account.
Variable life insurance differs from whole life, where the insurer's general account supports guaranteed cash values and fixed premiums. It also differs from universal life, which emphasizes flexible premiums and adjustable death-benefit structures. Variable universal life combines flexible-premium features with separate- account investment options. All such products must be described accurately because the potential for growth is accompanied by potential loss.
Because variable life is a security as well as an insurance product, a producer generally needs appropriate securities registration and authorization in addition to life insurance licensing. Suitability is especially important. The product may be appropriate only for a consumer with a long time horizon, tolerance for market volatility, and a need for permanent life insurance. It should not be sold as a guaranteed investment or as equivalent to a fixed life policy.
References/topics from the Study Guide: Variable Life Insurance; Separate Accounts; General Accounts; Securities Registration; Investment Risk; Suitability.
60. Frage
Group health policies MUST provide which of the following benefits?
Antwort: A
Begründung:
Nevada requires group health insurance policies to include benefits for expenses arising from hospice care.
Hospice care is designed for individuals facing terminal illness and focuses on comfort, pain and symptom management, emotional support, and assistance for the patient and family rather than curative treatment.
The group-policy required-provisions statute specifically includes hospice-care benefits. It also recognizes benefits for care at home or health supportive services when prescribed by a physician and otherwise covered if provided in a medical facility. This reflects the policy goal of allowing appropriate end-of-life care in a setting suited to the patient's needs.
Adult vision care and adult dental care are not universally required benefits under every group health policy.
They may be offered through separate policies, riders, employer benefit arrangements, or plan designs.
Cosmetic surgery is generally not a mandatory health insurance benefit and may be excluded unless medically necessary or required because of injury, congenital condition, reconstruction, or another covered circumstance.
The key examination point is that hospice care is a specifically required group-policy benefit in Nevada, while the other choices may be optional, limited, or excluded depending on the plan.
Study Guide references/topics: group health required provisions; hospice care; mandated benefits; NRS 689B.
030 .
61. Frage
Which of the following statements is CORRECT about Medicare?
Antwort: B
Begründung:
Medicare is a federal social insurance program that provides hospital and medical expense coverage to eligible persons. Therefore, choice B is correct. Medicare Part A primarily covers inpatient hospital care, skilled nursing facility care under qualifying conditions, hospice care, and certain home health services.
Medicare Part B primarily covers physician services, outpatient care, preventive services, durable medical equipment, and other medically necessary services. Choice A describes Medicaid, which is a needs-based medical assistance program jointly administered by federal and state governments. Choice C is incorrect because Medicare also serves people age 65 or older and individuals with qualifying end-stage renal disease or ALS; it is not limited to totally disabled persons. Choice D is incorrect because physician bills are generally associated with Part B, not Part A. Medicare beneficiaries may also choose Medicare Advantage plans, which provide Medicare-covered benefits through private plans, and may obtain prescription drug coverage under Part D. Study Guide References/Topics: Social Insurance Programs; Medicare Parts A and B; Federal Health Programs.
62. Frage
Which rider allows a terminally ill insured to receive part of the death benefit while still alive, subject to the policy terms?
Antwort: D
Begründung:
An accelerated death benefit rider permits an insured who meets the rider's qualifying conditions to receive a portion of the policy's death benefit while alive. Qualifying conditions commonly include terminal illness and may include chronic illness or other severe conditions, depending on the contract. The advance is not additional insurance. It is an acceleration of part of the death benefit otherwise payable at death. As a result, the remaining death benefit available to beneficiaries is reduced by the amount paid, together with any applicable charges or adjustments under the policy.
This rider can provide funds for medical care, home modifications, long-term care, living expenses, or other needs created by a serious illness. However, the producer must explain that eligibility is determined by the contract and supporting medical documentation. The rider should not be described as a replacement for comprehensive health insurance, disability income protection, or long-term-care insurance.
The other choices serve different purposes. A guaranteed-insurability rider allows future purchases of coverage without evidence of insurability at stated times or events. A payor-benefit rider waives premiums if a designated payor becomes disabled or dies. An accidental-death rider pays an additional benefit for qualifying accidental death.
References/topics from the Study Guide: Living Benefits; Accelerated Death Benefit Rider; Terminal Illness; Policy Riders; Beneficiary Considerations.
63. Frage
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