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| Section | Objectives |
|---|---|
| Health Insurance Policy Provisions | - Claims and Benefits
|
| Accident and Health Insurance Fundamentals | - Medical Expense Insurance
|
| General Insurance Regulation | - Nevada Insurance Department and Regulatory Authority
|
| Government Health Insurance Programs | - Medicaid and Other Programs
|
| Producer Duties and Ethics | - Ethical Responsibilities
|
| Insurance Basics | - Insurance Contracts
|
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NEW QUESTION # 116
An incorporated licensee who seeks to do business under a fictitious name is required to file a document about the name with the:
Answer: C
Explanation:
An incorporated insurance licensee using a name other than its true legal name must obtain approval and file the required fictitious-name documentation with the Nevada Insurance Commissioner. This ensures that insurance business is conducted under a name that has been reviewed, recorded, and can be connected to the actual licensed person or entity responsible for the transaction. It supports consumer protection, regulatory oversight, complaint handling, and enforcement of licensing laws.
Nevada's producer-licensing law requires an applicant or licensee wishing to use a name other than the true name shown on the license to submit a request for approval and file with the Commissioner a certified copy of the applicable certificate. The purpose is not merely administrative. A producer may not use a trade, assumed, or fictitious name in a way that could conceal the responsible licensee or mislead an insurance consumer.
The Attorney General, NAHU, and NAIFA do not approve fictitious names used by Nevada insurance licensees. The Nevada Division of Insurance, acting through the Commissioner, is the proper regulatory authority.
Study Guide references/topics: Nevada producer licensing; use of true or fictitious names; regulatory authority of the Commissioner; NRS 683A.301 .
NEW QUESTION # 117
Life insurance death proceeds paid to a named beneficiary are generally:
Answer: C
Explanation:
Life insurance death proceeds paid to a named beneficiary are generally excluded from the beneficiary's gross income for federal income-tax purposes. This favorable treatment is one reason life insurance is widely used for family income protection, estate liquidity, business continuation, and debt protection. However, the producer should use the word "generally" because exceptions and special circumstances can affect taxation.
For example, interest paid by the insurer because it retains proceeds under an interest option is generally taxable as interest income. Transfers of a policy for valuable consideration can create a transfer-for-value issue. Business-owned life insurance can involve additional notice, consent, and tax rules. Estate-tax treatment is also separate from income-tax treatment; incidents of ownership or other estate-planning facts may cause proceeds to be included in the insured's taxable estate even though the beneficiary does not owe income tax on the benefit.
Premiums paid for personally owned life insurance are generally not deductible. The producer should not provide individualized tax or legal advice. The proper explanation is that life insurance provides a generally income-tax-favored death benefit, while policy ownership, beneficiary designation, business arrangements, and estate planning should be reviewed with qualified advisers.
References/topics from the Study Guide: Life Insurance Taxation; Death Proceeds; Transfer-for-Value Rule; Estate Tax Concepts; Business-Owned Life Insurance.
NEW QUESTION # 118
A Long-Term Care policy provides coverage for:
Answer: C
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 # 119
Under a Disability policy, the Elimination period is:
Answer: C
Explanation:
The elimination period is the waiting period that must pass after disability begins before disability income benefits become payable. Choice C is correct because it performs a function similar to a deductible, but it is measured in time rather than dollars. For example, a policy may require an insured to remain disabled for 30,
60, 90, or 180 days before benefits begin. The insured bears the financial impact of the disability during that initial period, just as an insured bears a deductible before medical expense benefits apply. A longer elimination period generally reduces the policy premium because the insurer begins payments later and may avoid paying shorter-duration claims. The elimination period is not necessarily longer for accidents than sickness; many policies use the same waiting period for both. It is selected under the policy terms, rather than being an undefined period solely controlled by the insurer. It is also not the same as a probationary period, which is a period at the beginning of a policy during which sickness losses may be excluded. Study Guide References/Topics: Policy Provisions, Clauses, and Riders; Disability Income Insurance; Elimination Period.
NEW QUESTION # 120
Under a typical coordination-of-benefits rule, a child is covered under both parents' group health plans.
Which plan is generally primary when the parents are married and neither plan contains an exception?
Answer: A
Explanation:
Coordination of benefits, or COB, establishes the order in which multiple health plans pay when an insured is covered by more than one plan. For a dependent child covered by both married parents' group health plans, the common "birthday rule" generally makes primary the plan of the parent whose birthday occurs earlier in the calendar year. The rule compares the month and day of birth, not the year. If both birthdays are the same, the plan that has covered the parent longer is generally primary.
The primary plan pays first according to its own policy terms. The secondary plan then considers the remaining eligible expense and may pay an additional amount, subject to its coordination-of-benefits provision. COB is intended to prevent duplicate recovery exceeding the actual covered expense while still allowing the insured to receive the benefit of multiple coverages.
Special rules can apply in divorce, custody, court-order, active-versus-retired employee, Medicare, and other situations. The producer should never assume that one generic rule governs every family arrangement. Plan documents and applicable law control. For examination purposes, the birthday rule is the standard answer when the parents are married and no special circumstance is stated.
References/topics from the Study Guide: Coordination of Benefits; Primary and Secondary Coverage; Birthday Rule; Group Health Insurance; Dependent Coverage.
NEW QUESTION # 121
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