InsNV_Health02 Test Preparation, InsNV_Health02 Cert Exam

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Insurance Licensing InsNV_Health02 Exam Syllabus Topics:

SectionWeightObjectives
Nevada Statutes and Codes Common to Life, Health, Property, and Casualty Insurance20%- Nevada Life and Health Insurance Guaranty Association
- Insurance Commissioner
  • 1. Examinations
    • 2. Notice and hearings and penalties
      • 3. General powers and duties
        - Definitions
        • 1. Certificate of authority
          • 2. Domestic, foreign, and alien
            • 3. Transacting insurance
              • 4. Cost-sharing
                • 5. Authorized and unauthorized
                  • 6. Premiums
                    • 7. Insurer
                      - Marketing Practices
                      • 1. Required records and record retention
                        • 2. Fiduciary responsibilities
                          • 3. Unfair practices
                            • Unfair claims methods and practices and settlement of claims
                            • Rebating and inducement
                            • Twisting
                            • Misrepresentation
                            • Fraud
                            • Unfair discrimination
                            • Defamation
                          • 4. Affordable Care Act
                            • 5. Silver State Health Insurance Exchange
                              • 6. Commissions and payment restrictions
                                - Licensing
                                • 1. Name of licensee
                                  • 2. Termination of license
                                    • 3. Renewal and continuing education
                                      • 4. Persons required to be licensed
                                        • 5. Suspension, revocation, and refusal of license
                                          • 6. Obtaining a license
                                            Nevada Statutes and Codes Pertinent to Health Insurance Only14%- Coverage for reconstructive surgery
                                            - Long Term Care
                                            - Hospice care
                                            - Mandatory policy clauses and provisions
                                            • 1. Coverage for physical handicap or intellectual disability for dependent children
                                              • 2. Coverage for newborn children
                                                • 3. Coverage for preventive healthcare services
                                                  - Medicare
                                                  • 1. Prescription Drug Plan
                                                    • 2. Medicare supplement regulation
                                                      • 3. Medicare Advantage Plans
                                                        - Availability of coverage for mental health and treatment of alcohol abuse and drug abuse
                                                        Accident & Health – General Knowledge50%- Types of Policies
                                                        • 1. Disability income
                                                          • Individual disability income policy
                                                          • Business overhead expense policy
                                                          • Business disability buyout policy
                                                          • Group disability income policy
                                                          • Key employee policy
                                                        • 2. Accidental death and dismemberment
                                                          • 3. Medicare supplement policies
                                                            • 4. Individual and Group Long Term Care
                                                              • Eligibility
                                                              • Levels of care
                                                            • 5. Other policies
                                                              • Dental
                                                              • Vision
                                                              • Cancer
                                                              • Critical illness or specified disease
                                                              • Worksite employer-sponsored
                                                              • Hospital indemnity
                                                              • Short-term medical
                                                              • Accident
                                                            • 6. Group insurance
                                                              • Differences between individual and group contracts
                                                              • General characteristics
                                                              • COBRA
                                                            • 7. Medical expense insurance
                                                              • Basic hospital, medical, and surgical policies
                                                              • Major medical policies
                                                              • Health Maintenance Organizations
                                                              • Preferred Provider Organizations
                                                              • Point of Service plans
                                                              • Flexible Spending Accounts
                                                              • High Deductible Health Plans and Health Savings Accounts
                                                              • Health Reimbursement Accounts
                                                            - Field Underwriting Procedures
                                                            • 1. Completing the application
                                                              • 2. Contract law
                                                                • Elements of a contract
                                                                • Insurable interest
                                                                • Warranties and representations
                                                                • Unique aspects of the insurance contract
                                                              • 3. Replacement
                                                                • 4. Sources of insurability and HIPAA privacy information
                                                                  • 5. Submitting application and initial premium to company for underwriting
                                                                    • 6. Explaining policy provisions, riders, exclusions, and ratings
                                                                      • 7. Initial premium payment and receipt
                                                                        • 8. Policy delivery
                                                                          - Policy Provisions, Clauses, and Riders
                                                                          • 1. Other provisions and clauses
                                                                            • Insuring clause
                                                                            • Free look
                                                                            • Consideration clause
                                                                            • Probationary period
                                                                            • Elimination period
                                                                            • Waiver of premium
                                                                            • Exclusions and limitations
                                                                            • Preexisting conditions
                                                                            • Coinsurance
                                                                            • Deductibles
                                                                            • Eligible expenses
                                                                            • Copayments
                                                                            • Pre-authorizations and prior approval requirements
                                                                            • Usual, reasonable, and customary charges
                                                                            • Lifetime, annual, or per cause maximum benefit limits
                                                                          • 2. Rights of renewability
                                                                            • Noncancelable
                                                                            • Cancelable
                                                                            • Guaranteed renewable
                                                                          • 3. Riders
                                                                            • Impairment and exclusions
                                                                            • Guaranteed insurability
                                                                            • Future increase option
                                                                          • 4. Mandatory and optional provisions
                                                                            • Entire contract
                                                                            • Time limit on certain defenses
                                                                            • Grace period
                                                                            • Reinstatement
                                                                            • Notice of claim
                                                                            • Claim forms
                                                                            • Proof of loss
                                                                            • Time of payment of claims
                                                                            • Payment of claims
                                                                            • Physical examination and autopsy
                                                                            • Legal actions
                                                                            • Change of beneficiary
                                                                            • Misstatement of age or gender
                                                                            • Change of occupation
                                                                            • Illegal occupation
                                                                            • Relation of earnings to insurance
                                                                          - Other Insurance Concepts
                                                                          • 1. Primary and contingent beneficiaries
                                                                            • 2. Subrogation
                                                                              • 3. Tax treatment of premiums and proceeds of insurance contracts
                                                                                • 4. Cost containment
                                                                                  • 5. Total, partial, recurrent, and residual disability
                                                                                    • 6. Workers Compensation
                                                                                      • 7. Dependent children benefits
                                                                                        • 8. Occupational vs. non-occupational
                                                                                          • 9. Modes of premium payments
                                                                                            • 10. Managed care
                                                                                              • 11. Nonduplication and coordination of benefits
                                                                                                • 12. Owner's rights
                                                                                                  - Social Insurance
                                                                                                  • 1. Medicare Parts A, B, C, and D
                                                                                                    • 2. Social Security benefits
                                                                                                      • 3. Medicaid
                                                                                                        Nevada Statutes and Codes Common to Life and Health Insurance Only4%- Group life and health insurance
                                                                                                        • 1. Eligible groups
                                                                                                          • 2. Required provisions
                                                                                                            - Advertising
                                                                                                            - Credit life and health insurance

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                                                                                                            100% Pass Quiz 2026 Trustable InsNV_Health02: NV Accident and Health Test Preparation

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                                                                                                            Insurance Licensing NV Accident and Health Sample Questions (Q14-Q19):

                                                                                                            NEW QUESTION # 14
                                                                                                            Which statement is true of a variable life insurance policy?

                                                                                                            Answer: B

                                                                                                            Explanation:
                                                                                                            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.


                                                                                                            NEW QUESTION # 15
                                                                                                            A Major Medical policy insured is injured in an auto collision during a police chase. The occupants in the police car are killed. The insured is convicted of reckless driving and manslaughter. If the insured files a claim, the insurance company will MOST likely take which of the following actions?

                                                                                                            Answer: C

                                                                                                            Explanation:
                                                                                                            Major medical coverage pays covered medical expenses resulting from accidental injury or sickness, subject to the policy's stated exclusions and limitations. The facts establish reckless and criminal conduct, but they do not establish an intentional self-inflicted injury or identify a policy exclusion that removes coverage.
                                                                                                            Therefore, choice A is the best answer: the insurer will pay the covered benefits according to the policy.
                                                                                                            Insurance examination questions require careful separation of criminal conduct from intentional injury.
                                                                                                            Reckless driving and a resulting conviction do not automatically mean that the insured intended to injure himself. A health insurer may deny a claim only when a valid policy exclusion, limitation, misrepresentation defense, or other contract basis applies. The insurer does not reduce benefits merely to "partial benefits" because of the conviction, and it does not return all premiums after denying a properly covered accidental- injury claim. The controlling analysis is the policy language, including exclusions for intentional self-inflicted injury, war, occupational losses, or other listed circumstances. Study Guide References/Topics: Policy Provisions, Clauses, and Riders; Major Medical Insurance; Exclusions and Limitations.


                                                                                                            NEW QUESTION # 16
                                                                                                            What is the minimum age requirement for a natural person applying for a resident Nevada producer license?

                                                                                                            Answer: D

                                                                                                            Explanation:
                                                                                                            A natural person applying for a resident Nevada producer license must be at least 18 years old. Age is only one part of the licensing standard. Before approving a resident producer application, the Commissioner must also find that the applicant has not committed an act that would justify refusal, suspension, or revocation of a license; has paid the applicable fees; and has passed the required examination for the requested line of authority unless an examination exemption applies.
                                                                                                            A life and health producer must hold the appropriate line or lines of authority before selling, soliciting, or negotiating those classes of insurance. Nevada separately identifies life insurance and accident-and-health insurance as producer authorities. A producer must also comply with renewal, continuing education, appointment, recordkeeping, and reporting requirements as applicable.
                                                                                                            A business organization may also be licensed as a producer, but it must designate a properly licensed natural person who is authorized to transact business on its behalf and is responsible for the organization's compliance with Nevada insurance laws and regulations. Licensing is therefore not merely a test-passing event; it is an ongoing regulatory responsibility.
                                                                                                            For examination purposes, remember the basic resident-producer requirements: age 18 or older, proper application, fees, good character and eligibility, and examination success unless exempt.
                                                                                                            References/topics from the Study Guide: Nevada Producer Licensing; Resident Producer Requirements; Lines of Authority; License Application; NRS 683A.251.


                                                                                                            NEW QUESTION # 17
                                                                                                            A Long-Term Care policy provides coverage for:

                                                                                                            Answer: B

                                                                                                            Explanation:
                                                                                                            Long-term care insurance is designed primarily to cover services required when an insured cannot perform activities of daily living independently or has a severe cognitive impairment. Custodial care in a nursing home is a core example of long-term care coverage. Custodial care involves assistance with everyday personal needs, such as bathing, dressing, eating, transferring, toileting, and continence, rather than acute medical treatment.
                                                                                                            Long-term care benefits may be provided in a nursing home, assisted-living setting, adult day-care setting, or the insured's home, depending on the policy. Coverage can include skilled nursing care, intermediate care, custodial care, home health care, hospice care, respite care, and care-management services, subject to policy conditions and benefit triggers.
                                                                                                            Hospital-expense and medical-expense policies generally focus on acute treatment, physician services, surgery, hospitalization, and related medical costs. Medicare Supplement insurance is designed to help pay certain Medicare deductibles, coinsurance, and copayments; it is not long-term care insurance.
                                                                                                            The distinction is crucial: long-term care insurance addresses prolonged assistance and supervision resulting from chronic illness, disability, frailty, or cognitive impairment, whereas major medical insurance focuses principally on acute medical treatment.
                                                                                                            Study Guide references/topics: long-term care insurance; custodial care; skilled care; activities of daily living; nursing-home benefits; Nevada long-term-care regulations .


                                                                                                            NEW QUESTION # 18
                                                                                                            The Nevada Insurance Commissioner may revoke the license of any licensed producer who:

                                                                                                            Answer: A

                                                                                                            Explanation:
                                                                                                            Misappropriating money belonging to policyholders is a direct and serious ground for license revocation. A producer commonly receives premiums, return premiums, claim funds, or other property in the course of insurance business. Those funds must be handled honestly, promptly, and in accordance with the producer's fiduciary responsibilities. Using, converting, improperly withholding, or diverting that money violates Nevada producer-licensing law.
                                                                                                            The Commissioner may refuse to issue, suspend, revoke, or refuse to renew a producer's license and may impose administrative fines or other disciplinary action for specified misconduct. Misappropriation is specifically identified as conduct warranting discipline because it threatens consumers and undermines the integrity of the insurance marketplace.
                                                                                                            A civil judgment alone does not automatically establish a licensing-revocation ground under the wording of this question. Likewise, reporting requirements and address-change obligations may lead to administrative consequences when violated, but the question asks for the clear statutory cause for revocation.
                                                                                                            Misappropriation of policyholder money is the most direct and legally significant answer.
                                                                                                            Producers should maintain accurate premium records, promptly remit funds, segregate money when required, and never treat policyholder or insurer funds as personal assets.
                                                                                                            Study Guide references/topics: producer fiduciary duties; prohibited practices; license denial, suspension, and revocation; NRS 683A.451 .


                                                                                                            NEW QUESTION # 19
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