Insurance Licensing InsNV_Health02 Vce Exam | Latest InsNV_Health02 Braindumps Files

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Insurance Licensing InsNV_Health02 Exam Syllabus Topics:

Section	Weight	Objectives
Topic 1: Nevada Statutes and Codes Common to Life and Health Insurance Only	4%	- Credit life and health insurance - Advertising - Group life and health insurance 1. Eligible groups 2. Required provisions
Topic 2: Accident & Health – General Knowledge	50%	- Social Insurance 1. Social Security benefits 2. Medicaid 3. Medicare Parts A, B, C, and D - Field Underwriting Procedures 1. Explaining policy provisions, riders, exclusions, and ratings 2. Sources of insurability and HIPAA privacy information 3. Initial premium payment and receipt 4. Policy delivery 5. Submitting application and initial premium to company for underwriting 6. Replacement 7. Completing the application 8. Contract law Elements of a contract Insurable interest Warranties and representations Unique aspects of the insurance contract - Policy Provisions, Clauses, and Riders 1. Riders Impairment and exclusions Guaranteed insurability Future increase option 2. Rights of renewability Noncancelable Cancelable Guaranteed renewable 3. 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 4. 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 - Other Insurance Concepts 1. Cost containment 2. Modes of premium payments 3. Tax treatment of premiums and proceeds of insurance contracts 4. Primary and contingent beneficiaries 5. Subrogation 6. Managed care 7. Workers Compensation 8. Occupational vs. non-occupational 9. Total, partial, recurrent, and residual disability 10. Owner's rights 11. Nonduplication and coordination of benefits 12. Dependent children benefits - Types of Policies 1. Other policies Dental Vision Cancer Critical illness or specified disease Worksite employer-sponsored Hospital indemnity Short-term medical Accident 2. Group insurance Differences between individual and group contracts General characteristics COBRA 3. Medicare supplement policies 4. Disability income Individual disability income policy Business overhead expense policy Business disability buyout policy Group disability income policy Key employee policy 5. 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 6. Accidental death and dismemberment 7. Individual and Group Long Term Care Eligibility Levels of care
Topic 3: Nevada Statutes and Codes Pertinent to Health Insurance Only	14%	- Hospice care - Medicare 1. Prescription Drug Plan 2. Medicare Advantage Plans 3. Medicare supplement regulation - Coverage for reconstructive surgery - Mandatory policy clauses and provisions 1. Coverage for preventive healthcare services 2. Coverage for physical handicap or intellectual disability for dependent children 3. Coverage for newborn children - Availability of coverage for mental health and treatment of alcohol abuse and drug abuse - Long Term Care
Topic 4: Nevada Statutes and Codes Common to Life, Health, Property, and Casualty Insurance	20%	- Definitions 1. Transacting insurance 2. Domestic, foreign, and alien 3. Premiums 4. Certificate of authority 5. Cost-sharing 6. Insurer 7. Authorized and unauthorized - Marketing Practices 1. Affordable Care Act 2. Fiduciary responsibilities 3. Commissions and payment restrictions 4. Silver State Health Insurance Exchange 5. Unfair practices Unfair claims methods and practices and settlement of claims Rebating and inducement Twisting Misrepresentation Fraud Unfair discrimination Defamation 6. Required records and record retention - Nevada Life and Health Insurance Guaranty Association - Insurance Commissioner 1. Notice and hearings and penalties 2. General powers and duties 3. Examinations - Licensing 1. Persons required to be licensed 2. Name of licensee 3. Obtaining a license 4. Renewal and continuing education 5. Suspension, revocation, and refusal of license 6. Termination of license

>> Insurance Licensing InsNV_Health02 Vce Exam <<

Latest InsNV_Health02 Braindumps Files | InsNV_Health02 Latest Test Pdf

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Insurance Licensing NV Accident and Health Sample Questions (Q98-Q103):

NEW QUESTION # 98
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?

A. 30 days
B. 31 days
C. 45 days
D. 15 days

Answer: B

NEW QUESTION # 99
Under a Medicare Supplement policy that is issued in response to a direct solicitation, a policyowner may return the policy to the insurance company for a full premium refund within a MAXIMUM of how many days?

A. Sixty
B. Thirty
C. Forty-five
D. Ten

Answer: B

Explanation:
A Medicare Supplement policy issued in response to direct solicitation may be returned for a full premium refund within 30 days. This is commonly called a free-look or right-to-return period. It gives the policyowner time to examine the policy after delivery and decide whether the coverage is suitable.
Direct solicitation presents a heightened consumer-protection concern because the purchaser may not have received the same personal explanation and comparison assistance available in a face-to-face sale. The 30-day period allows the consumer to review benefits, exclusions, premiums, Medicare coordination, replacement implications, and suitability without financial penalty.
The policyowner should return the policy within the required period and follow the insurer's return instructions. Once timely returned, the insurer must refund the premium in accordance with the applicable rule. The free-look right does not mean that every policy can be cancelled at any time for a complete refund; it is a specific statutory or regulatory rescission period following delivery.
Ten, 45, and 60 days are common distractors because various insurance rules use different deadlines. For Medicare Supplement direct-solicitation policies, the tested maximum period is 30 days.
Study Guide references/topics: Medicare Supplement insurance; direct solicitation; free-look period; consumer protections; Nevada Medicare Supplement regulations .

NEW QUESTION # 100
The Nevada Life and Health Insurance Guaranty Association is financed by which of the following methods?

A. Assessing insureds
B. Assessing member insurance companies
C. Assessing a premium tax
D. Assessing agent association members

Answer: B

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 # 101
The Coinsurance clause in an individual Medical Expense policy refers to the:

A. insured ' s rights to have another person, such as a spouse or child, insured on the same policy
B. insurance company ' s right to join with another company to carry excessive coverage on a particular individual
C. insurance company ' s right to share claim experience with another company
D. insurance company ' s right to require the insured to share a certain percentage of the cost of each claim

Answer: D

Explanation:
Coinsurance is the contractual sharing of covered medical expenses between the insured and the insurer after any applicable deductible has been satisfied. Choice D is correc t. Under a common 80/20 coinsurance arrangement, for example, the insurer pays 80 percent of an eligible expense and the insured pays the remaining 20 percent, up to any out-of-pocket maximum or other plan limitation. Coinsurance reduces premium cost and encourages insureds to consider the cost of care, while preserving significant protection against major expenses. It does not refer to adding family members to a policy, which concerns eligibility or family coverage. It also does not describe insurers sharing risk with each other; that would involve reinsurance or other insurer-to-insurer arrangements. Coinsurance should be distinguished from a deductible, which is a specified dollar amount the insured pays before policy benefits begin. A copayment is instead a fixed dollar amount paid for a covered service. The exact coinsurance percentage, covered-charge definition, network rules, and annual out-of-pocket limit are determined by the policy. Study Guide References/Topics:
Policy Provisions, Clauses, and Riders; Medical Expense Insurance; Deductibles and Coinsurance.

NEW QUESTION # 102
A prospect submits an Accident and Health application with the premium and receives a conditional receipt.
The insurance company issues a policy and mails it to the insured, but the insured never receives it. Which of the following statements is CORRECT about this situation?

A. The policy is in force.
B. The policy will be in force as soon as the company issues a replacement policy.
C. The policy is not in force because delivery was not completed.
D. The policy will be in force five business days after the prospect notifies the company that the prospect has not received the policy.

Answer: A

Explanation:
The correct answer is D. A conditional receipt may provide temporary or conditional coverage when the application and required premium are submitted, subject to the receipt's terms and the applicant meeting underwriting requirements. Once the insurer approves the application, issues the policy, and mails it to the insured, the policy is generally considered delivered through constructive delivery. Physical receipt by the insured is not required when the insurer has completed issuance and mailing without retaining control over the policy. Accordingly, failure of the insured to receive the mailed policy does not, by itself, prevent the policy from being in force. Choice A incorrectly assumes that personal delivery is always essential. Choices B and C introduce conditions that are not part of the usual delivery rule. The policy's effective date remains governed by the application, conditional receipt, policy provisions, and underwriting approval. This question tests the distinction between actual delivery, where the insured personally receives the policy, and constructive delivery, where the insurer's completed mailing is sufficient to establish delivery. Study Guide References
/Topics: Completing the Application, Underwriting, and Delivering the Policy; Conditional Receipts; Policy Delivery.

NEW QUESTION # 103
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