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Insurance Licensing InsNV_Health02 Exam Syllabus Topics:

SectionObjectives
Topic 1: Accident and Health Insurance Fundamentals- Types of Health Insurance Policies
  • 1. Individual health insurance
    • 2. Managed care plans
      • 3. Group health insurance
        - Disability Income Insurance
        • 1. Disability definitions and benefits
          • 2. Elimination periods and benefit periods
            - Medical Expense Insurance
            • 1. Hospital, surgical, and physician expense coverage
              • 2. Major medical plans
                Topic 2: Insurance Basics- Insurance Contracts
                • 1. Contract elements
                  • 2. Policy provisions, riders, and exclusions
                    - Risk Management and Insurance Concepts
                    • 1. Types of risk and methods of handling risk
                      • 2. Insurance principles and contract characteristics
                        Topic 3: Health Insurance Policy Provisions- Claims and Benefits
                        • 1. Claim procedures
                          • 2. Benefit determination and payment
                            - Mandatory and Optional Provisions
                            • 1. Renewability provisions
                              • 2. Policy requirements and clauses
                                Topic 4: Producer Duties and Ethics- Sales Practices
                                • 1. Unfair trade practices
                                  • 2. Advertising and marketing rules
                                    - Ethical Responsibilities
                                    • 1. Consumer protection requirements
                                      • 2. Fiduciary responsibilities
                                        Topic 5: General Insurance Regulation- Nevada Insurance Department and Regulatory Authority
                                        • 1. Insurance laws, rules, and regulations
                                          • 2. Commissioner of Insurance powers and duties
                                            - Licensing Requirements and Responsibilities
                                            • 1. Producer licensing requirements
                                              • 2. Continuing education and license maintenance
                                                Topic 6: Government Health Insurance Programs- Medicare
                                                • 1. Medicare supplement insurance
                                                  • 2. Medicare parts and eligibility
                                                    - Medicaid and Other Programs
                                                    • 1. Medicaid eligibility and coverage

                                                      >> InsNV_Health02 Exam Questions <<

                                                      Insurance Licensing - InsNV_Health02 - High-quality NV Accident and Health Exam Questions

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                                                      Insurance Licensing NV Accident and Health Sample Questions (Q123-Q128):

                                                      NEW QUESTION # 123
                                                      Which person is the measuring life whose survival determines the timing and duration of annuity payments?

                                                      Answer: B

                                                      Explanation:
                                                      The annuitant is the person whose life expectancy is used to determine the amount, timing, or duration of annuity payments. The annuitant is not necessarily the contract owner or the beneficiary. In many personally owned annuities, one person may occupy more than one role, but examination questions frequently separate them. The owner controls contractual rights, including premium payments, beneficiary changes, withdrawals when permitted, and surrender decisions. The annuitant is the measuring life. The beneficiary receives remaining contract value or death proceeds if the owner or annuitant dies, depending on the contract design.
                                                      During the accumulation period, the owner pays premiums or transfers funds into the annuity. During the annuitization period, the accumulated value is converted into a stream of income payments. The annuitant's age and selected payout option influence the payment calculation. A life-income option normally provides larger periodic payments for an older annuitant because the expected payment period is shorter.
                                                      Do not confuse the annuitant with the insured under life insurance. Life insurance is designed primarily to create a death benefit upon the insured's death. An annuity is designed primarily to provide income during life, although death-benefit provisions may apply before annuitization.
                                                      References/topics from the Study Guide: Annuities; Parties to an Annuity; Accumulation Period; Annuitization Period; Payout Options.


                                                      NEW QUESTION # 124
                                                      Under a life insurance policy with a revocable beneficiary designation, who normally has the authority to change the beneficiary?

                                                      Answer: C

                                                      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 # 125
                                                      Under a Gold health insurance plan, an insurer would be expected to pay which percentage of medical costs?

                                                      Answer: B

                                                      Explanation:
                                                      A Gold Marketplace health plan has an actuarial value of approximately 80%. Therefore, the insurer is expected to pay about 80% of covered medical costs for a standard population, while enrollees as a group pay approximately 20% through deductibles, copayments, and coinsurance.
                                                      Actuarial value does not mean that the insurer pays exactly 80% of every individual's bills. A particular insured may pay more or less than 20% in a year depending on the services used, the plan's deductible, copayment structure, provider network, prescription-drug costs, and whether the annual out-of-pocket maximum has been reached. It is an overall measure of expected cost sharing for covered benefits.
                                                      The standard metal levels are Bronze at 60%, Silver at 70%, Gold at 80%, and Platinum at 90%. Gold plans generally have higher monthly premiums than Bronze or Silver plans but lower cost sharing when health care is received. Platinum plans generally have the highest premiums and the lowest cost sharing.
                                                      Study Guide references/topics: Affordable Care Act; Marketplace plans; metal levels; actuarial value; deductibles; copayments; HealthCare.gov plan categories .


                                                      NEW QUESTION # 126
                                                      Which premium-payment mode usually results in the lowest total annual premium cost for the policyowner?

                                                      Answer: D

                                                      Explanation:
                                                      Annual premium payment generally produces the lowest total cost over the policy year because the insurer receives the full annual premium at the beginning of the coverage period. Monthly, quarterly, and semiannual payment modes are convenient for budgeting, but they commonly include an additional charge or produce a higher total annual premium. The difference reflects the insurer's additional administrative expense and the fact that the insurer receives portions of the premium later.
                                                      Premium mode does not change the policy's face amount, underwriting classification, or contractual benefits.
                                                      It changes only the schedule and total cost of paying the premium. A producer should present all available modes clearly and explain the actual amount due under each option. A consumer with predictable annual cash flow may prefer annual mode to reduce total cost, while a consumer who needs more frequent payments may choose a higher-cost mode to preserve affordability and avoid lapse.
                                                      This issue is distinct from the grace period. The grace period protects the policyowner after a premium due date by allowing a limited time to make payment before coverage lapses. Premium mode establishes how frequently the regular premium is due; it does not eliminate the policyowner's obligation to pay.
                                                      References/topics from the Study Guide: Premium Payment; Premium Modes; Grace Period; Policy Lapse; Life Insurance Contract Provisions.


                                                      NEW QUESTION # 127
                                                      Insurance for the primary purpose of repaying a loan in the event of disability is referred to as:

                                                      Answer: D

                                                      Explanation:
                                                      Credit Accident and Health insurance is insurance on a debtor that provides indemnity for payments or debt becoming due on a specific loan or credit transaction while the debtor is disabled as defined by the policy. Its primary purpose is to protect the borrower and creditor by helping repay the outstanding debt when disability prevents the borrower from working or making scheduled payments.
                                                      The coverage may pay periodic loan installments during a qualifying disability or, depending on policy design, provide benefits related to the unpaid debt. It is connected to a specific credit obligation rather than serving as broad disability-income protection. The benefit is limited by the loan terms, policy provisions, waiting period, disability definition, and maximum benefit duration.
                                                      Guaranteed Asset Protection, or GAP, generally addresses the difference between an automobile's outstanding loan balance and its actual cash value after a covered total loss. Credit life insurance pays or reduces debt upon the debtor's death, not disability. "Loan Repayment policy" is not the standard statutory insurance term.
                                                      The examination distinction is that disability-related loan protection is Credit Accident and Health insurance, while death-related loan protection is Credit Life insurance.
                                                      Study Guide references/topics: credit insurance; disability protection; credit accident and health insurance; debtor; NRS 690A.0135 .


                                                      NEW QUESTION # 128
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