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| Section | Objectives |
|---|---|
| Accident and Health Insurance Fundamentals | - Types of Health Insurance Policies
|
| General Insurance Regulation | - Licensing Requirements and Responsibilities
|
| Health Insurance Policy Provisions | - Claims and Benefits
|
| Producer Duties and Ethics | - Sales Practices
|
| Government Health Insurance Programs | - Medicare
|
| Insurance Basics | - Insurance Contracts
|
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NEW QUESTION # 36
Nevada insurance laws define a domestic insurance company as one formed under the laws of:
Answer: C
Explanation:
A domestic insurer in Nevada is an insurer formed under the laws of Nevada, unless it has converted to foreign-insurer status. Therefore, "the state of Nevada only" is the correct answer.
The terms domestic, foreign, and alien describe the jurisdiction in which an insurer is formed or domiciled; they do not describe the insurer's size, financial condition, or whether it is authorized to do business in Nevada. A foreign insurer is formed under the laws of another jurisdiction, generally another U.S. state, but may be authorized to transact insurance in Nevada. An alien insurer is formed under the laws of a country other than the United States.
An insurer may be domestic in one state and foreign in every other state. For example, an insurer incorporated under Nevada law is domestic in Nevada but foreign in California, Arizona, or any other state. Conversely, a company formed in another state is foreign in Nevada even if it holds a Nevada certificate of authority.
Study Guide references/topics: domestic insurers; foreign insurers; alien insurers; insurer domicile; NRS
679A.090 .
NEW QUESTION # 37
Which of the following policies provides a specified income benefit when the insured person becomes unable to work because of illness or accident?
Answer: C
Explanation:
Disability Income insurance is designed to replace a portion of an insured's earned income when illness or accidental injury prevents the insured from working. Choice D is correct. Unlike medical expense insurance, which pays for covered health-care costs, disability income coverage pays a stated periodic benefit- commonly monthly-to help the insured meet ordinary financial obligations during disability. Benefits are subject to the policy definition of disability, elimination period, benefit period, maximum monthly benefit, and any offsets or residual-disability provisions. "Emergency Income," "Supplemental Income," and
"Temporary Income" are not standard policy classifications that describe the core income-replacement product tested here. Disability policies may be written on an own-occupation, modified-own-occupation, or any-occupation basis, and that definition materially affects when benefits are payable. Individual disability income is commonly purchased by self-employed persons, professionals, and others who want income protection beyond employer-sponsored benefits. Group disability plans often provide short-term and long- term benefits, while individual policies can offer more customized benefit levels, riders, and noncancellable or guaranteed-renewable features. Study Guide References/Topics: Types of Health Insurance Policies; Disability Income Insurance; Income Replacement.
NEW QUESTION # 38
Which statement best describes Medicare Part B?
Answer: B
Explanation:
Medicare Part B is the medical-insurance portion of Original Medicare. It generally helps cover physician services, outpatient care, diagnostic services, preventive care, durable medical equipment, and other covered medical services. Enrollment is generally voluntary, although it may be automatic for certain people who are already receiving Social Security benefits. Most individuals pay a monthly Part B premium, and higher- income beneficiaries may pay an income-related additional amount.
Part B should not be confused with Medicare Part D, which provides outpatient prescription-drug coverage, or with Medicaid, which is a joint federal-state program for eligible individuals with limited income and resources. Part B also differs from Part A, which is primarily hospital insurance. Delaying Part B enrollment without qualifying employer coverage can result in late-enrollment penalties and gaps in coverage, so producers should avoid casual advice and instead direct consumers to current Medicare enrollment guidance.
When discussing Medicare-related products, producers must accurately identify whether a client has Original Medicare, a Medicare Advantage plan, a Medicare supplement policy, and/or a Part D prescription-drug plan.
These arrangements have different rules, premiums, provider networks, and cost-sharing structures.
References/topics from the Study Guide: Medicare Part B; Original Medicare; Enrollment Periods; Medicare Premiums; Medicare Supplement Products.
NEW QUESTION # 39
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 # 40
Which of the following statements is CORRECT about a Disability Income policy with a Guaranteed Insurability rider?
Answer: C
Explanation:
A Guaranteed Insurability rider gives the disability income policyowner the right to purchase additional disability income coverage at stated future option dates without furnishing evidence of insurability. The rider is valuable because an insured's income may increase over time while health may decline; the rider allows benefit amounts to be increased when the option is exercised, subject to the rider's conditions and insurer limits. Therefore, choice C is correct. The rider does not guarantee a premium rate for life. Premiums for the added coverage are based on the insured's attained age and the insurer's rates applicable when the additional coverage is purchased. It also does not require periodic proof of insurability; eliminating that requirement is the central purpose of the rider. The existing policy remains in force and normally does not have to be exchanged for a new policy. On an examination, distinguish guaranteed insurability from noncancellable and guaranteed renewable provisions: those provisions concern renewability and premiums, whereas the rider concerns the future purchase of additional benefits. Study Guide References/Topics: Policy Provisions, Clauses, and Riders; Disability Income Insurance; Optional Benefits Riders.
NEW QUESTION # 41
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