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Insurance Licensing InsNV_Health02 Exam Syllabus Topics:

SectionWeightObjectives
Accident and Health — General Knowledge~68%- Social Insurance / Government Plans
  • 1. Medicaid
  • 2. Medicare (Parts A, B, C, D)
  • 3. Social Security Disability Benefits
- Types of Health Insurance Policies
  • 1. Accidental Death & Dismemberment
  • 2. Group Health Insurance
  • 3. Long-Term Care (LTC) Insurance
  • 4. Disability Income Insurance
  • 5. Medicare Supplement Policies
  • 6. Medical Expense / Major Medical Insurance
  • 7. Limited Benefit Plans
- Insurance Concepts and Underwriting
  • 1. Premiums and Renewal
  • 2. Application and Underwriting
  • 3. Insurance Basics and Risk
- Policy Provisions, Clauses & Riders
  • 1. Other Provisions and Clauses
  • 2. Common Riders
  • 3. Optional Provisions
  • 4. Mandatory Uniform Provisions
Nevada Statutes, Rules and Regulations~32%- General State Insurance Regulations
  • 1. Insurance Guaranty Associations
  • 2. Definitions and General Provisions
  • 3. Marketing Practices and Unfair Trade
  • 4. Insurance Commissioner Authority
  • 5. Agent Licensing Requirements
- Nevada Health-Specific Regulations
  • 1. Replacement and Free-Look Provisions
  • 2. Group and Credit Health Rules
  • 3. Advertising and Disclosure Rules

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Insurance Licensing NV Accident and Health Sample Questions (Q63-Q68):

NEW QUESTION # 63
A long-term-care policy commonly becomes eligible to pay benefits when the insured is certified as chronically ill because the insured:

Answer: C

Explanation:
Long-term-care insurance commonly uses functional and cognitive triggers to determine benefit eligibility. A typical trigger is certification that the insured cannot perform at least two activities of daily living, or ADLs, without substantial assistance for the required period. Common ADLs include bathing, continence, dressing, eating, toileting, and transferring. Another common trigger is severe cognitive impairment requiring substantial supervision to protect the insured's health and safety.
Long-term-care coverage is not based merely on reaching a certain age, unemployment, or a premium- payment issue. It is designed to help pay for qualifying long-term services when the insured needs ongoing assistance because of chronic illness, disability, or cognitive impairment. Covered services may include nursing-home care, assisted living, adult day care, home health care, hospice care, and respite care, depending on the policy.
The producer should explain the elimination period, daily or monthly benefit limit, benefit period, inflation- protection options, facility restrictions, and policy exclusions. An insured may need care for years, so a policy with a low daily benefit or short benefit period may not meet the client's needs. Suitability requires evaluating likely care preferences, assets, family support, and affordability.
References/topics from the Study Guide: Long-Term Care Insurance; Activities of Daily Living; Cognitive Impairment; Benefit Triggers; Elimination Period.


NEW QUESTION # 64
As a condition to granting a loan, a creditor can:

Answer: A

Explanation:
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 .


NEW QUESTION # 65
Under an Accidental Death and Dismemberment policy, in which of the following circumstances will an autopsy NOT be performed?

Answer: D

Explanation:
The correct answer is B. An AD & D policy may give the insurer the right to conduct an autopsy when death occurs, provided the autopsy is not prohibited by law. The autopsy provision helps the insurer determine whether the cause of death falls within the policy's accidental-death coverage and whether an exclusion applies. A beneficiary's refusal does not necessarily defeat the insurer's contractual right if applicable law permits the examination. The fact that death resulted from illness rather than an accident may affect whether an AD & D benefit is payable, but it does not itself state the legal restriction on performing an autopsy.
Likewise, an accidental cause of death is precisely the type of circumstance in which the insurer may need medical evidence to verify coverage. The insurer's right is not unlimited: it must comply with legal requirements, including restrictions imposed by statute, court order, or other controlling authority. The exam rule is straightforward: the insurer may conduct an autopsy at its own expense unless doing so is prohibited by law. Study Guide References/Topics: Policy Provisions, Clauses, and Riders; Accidental Death and Dismemberment; Autopsy Provision.


NEW QUESTION # 66
Group coverage for a handicapped dependent child may be continued if the primary insured submits the required proof to the insurance company within what MAXIMUM period of time after the child reaches the limiting age?

Answer: A

Explanation:
A group health policy that terminates dependent-child coverage at a stated limiting age must continue coverage for an eligible dependent child who remains incapable of self-sustaining employment because of a qualifying disability and who remains dependent on the insured group member for support and maintenance.
To preserve that continuation right, the required proof must be furnished within 31 days after the child reaches the policy's limiting age.
This is a time-sensitive protection. The purpose is to prevent automatic termination of coverage solely because a dependent reaches the normal age limit when the child remains disabled and financially dependent.
After initial proof is provided, the insurer may require continuing proof of incapacity and dependency, but it may not demand that proof more often than permitted by law.
The 31-day rule should be distinguished from notice periods for newborn coverage, conversion rights, premium grace periods, and claim notices. Each insurance provision may use a different time period, so examination questions often test the exact statutory deadline.
Study Guide references/topics: group health dependents; limiting age; continuation of coverage; NRS 689B.
035 .


NEW QUESTION # 67
Which of the following information is included in the Consideration clause in an Accident and Health policy?

Answer: D


NEW QUESTION # 68
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