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| Section | Weight | Objectives |
|---|---|---|
| Topic 1: Nevada Statutes, Rules and Regulations | ~32% | - Nevada Health-Specific Regulations
|
| Topic 2: Accident and Health — General Knowledge | ~68% | - Insurance Concepts and Underwriting
|
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NEW QUESTION # 71
The Nevada Life and Health Insurance Guaranty Association is financed by which of the following methods?
Answer: C
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 # 72
After appointing a producer as its agent, when must an insurer generally file its notice of appointment with the Nevada Commissioner?
Answer: D
Explanation:
In Nevada, an insurer appointing a producer as its agent must generally file a notice of appointment with the Commissioner within 15 days after the agency contract is executed or the first application for insurance is submitted, whichever event triggers the statutory timing. The appointment establishes the producer's authority to act as the insurer's agent for the applicable business. An agent is a producer compensated by the insurer who sells, solicits, or negotiates insurance for that insurer.
A producer who is not acting as an insurer's agent may act as a broker, subject to the statutory definition and applicable requirements. The distinction matters because an agent represents the insurer in the agency relationship, while a broker acts on behalf of the insured or prospective insured and lacks authority to bind an insurer through the broker's own actions.
The appointment requirement does not replace the producer-license requirement. Before selling, soliciting, or negotiating a class of insurance in Nevada, the person must hold the appropriate line of authority. A life or health producer must therefore have the relevant licensing authority and, when acting as an insurer's agent, be properly appointed.
Examination questions often test both the 15-day filing timeline and the difference between an agent and a broker.
References/topics from the Study Guide: Producer Appointments; Agent and Broker Distinction; Insurer Appointments; Nevada Producer Licensing; NRS 683A.321.
NEW QUESTION # 73
Which of the following persons is NOT required to be licensed by the Nevada Insurance Commissioner?
Answer: B
Explanation:
A salaried insurance company employee performing only clerical and administrative work is not required to hold an insurance producer license. The exemption applies when the employee does not sell, solicit, or negotiate insurance and is not compensated by commission based on insurance transactions.
Licensing is required for persons whose activities bring them into the regulated functions of insurance production, brokering, adjusting, or other licensed insurance activity. A person who procures insurance for an insured is acting in a producer or broker capacity and requires appropriate authority. An individual involved in investigating and settling claims may require an adjuster license depending on the duties performed.
Likewise, an agency clerk who receives commissions related to processed applications is no longer functioning solely as a clerical employee; commission-based activity indicates involvement in the insurance transaction.
The distinction is based on the actual work performed, not merely the person's job title. A company may call someone an assistant, representative, clerk, or customer-service employee, but the individual must be licensed if the person sells, solicits, negotiates, or otherwise performs regulated insurance functions.
Study Guide references/topics: producer licensing; licensing exemptions; clerical employees; sales, solicitation, and negotiation; NRS 683A.117 .
NEW QUESTION # 74
An insured who owns a Disability Income policy forgot to pay the premium due on July 1. If the insured files a disability claim on July 31, the insurance company will MOST likely:
Answer: B
Explanation:
The policy remains in force during its contractual grace period after a premium becomes due. For individual accident and health policies, the required grace period generally depends on premium mode: seven days for weekly premiums, ten days for monthly premiums, and 31 days for other premium modes. A claim occurring within the applicable grace period is not automatically denied simply because the premium has not yet been paid. Instead, the insurer may pay the covered claim and deduct the overdue premium from the amount otherwise payable. Therefore, choice B is the best answer. Reinstatement is unnecessary because the policy has not yet lapsed while the grace period is still running. Cancellation and return of all prior premiums would be inconsistent with the purpose of the grace-period provision. The question tests the difference between a late premium during grace and a lapsed policy after grace expires. Once grace expires without payment, coverage can lapse; if coverage later is reinstated, loss coverage may be subject to reinstatement provisions and limitations. Study Guide References/Topics: Policy Provisions, Clauses, and Riders; Grace Period; Disability Income Insurance.
NEW QUESTION # 75
Under an individual health policy issued in Nevada, a newborn is automatically covered for a MAXIMUM of how many days after birth?
Answer: C
Explanation:
A newborn is automatically covered under the applicable Nevada health-policy rule for 31 days after birth.
Coverage begins from the moment of birth and includes necessary care and treatment for injury or sickness, including medically diagnosed congenital defects and birth abnormalities.
To continue coverage beyond the initial 31-day period, the policy may require timely notice of the birth and payment of any additional premium or fee required by the insurer. The notification and payment requirement must be satisfied within the 31-day period if the policy requires it. This rule protects newborns during the immediate post-birth period, when medical care may be urgently necessary.
The automatic coverage is not limited to routine newborn care. It includes necessary treatment of medical conditions identified at birth, subject to the policy's applicable limits. The law also prevents the policy from excluding premature births under the mandated newborn coverage.
Two, five, and ten days are incorrect because they would not provide the statutory protection required for newborn coverage. The exam point is that the initial automatic period is 31 days, while continuation beyond that period may require prompt enrollment action by the insured.
Study Guide references/topics: individual health insurance; newborn coverage; congenital defects; notification requirements; Nevada newborn-coverage requirements .
NEW QUESTION # 76
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