InsNV_Health02ウェブトレーニング & InsNV_Health02参考書勉強

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Insurance Licensing InsNV_Health02 Exam Syllabus Topics:

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

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Insurance Licensing NV Accident and Health 認定 InsNV_Health02 試験問題 (Q89-Q94):

質問 # 89
An insurer shall not issue an individual long-term care insurance contract in Nevada unless the insurer has received from the applicant:

A. a written designation of at least one person, in addition to the applicant, who must receive notice of any lapse or termination of coverage under the policy for nonpayment of premium
B. a designation by at least one person, in addition to the applicant, to accept liability for services provided to the applicant
C. a notarized waiver dated and signed by the applicant stating that the applicant has chosen not to designate another person to receive notice of any lapse or termination of coverage for nonpayment of premium
D. a written designation by the applicant to pay premium for long-term care insurance through either a payroll or pension deduction plan

正解：A

解説：
Nevada requires an individual long-term care insurer to obtain a written designation of at least one additional person who will receive notice if coverage is about to lapse or terminate for nonpayment of premium. This protection is intended to reduce unintended lapses, particularly when an insured experiences cognitive decline, illness, disability, or another circumstance that interferes with managing premiums.
The applicant may instead submit a written waiver, dated and signed, stating that the applicant chooses not to designate another person. The waiver is not required to be notarized. Because option B incorrectly adds a notarization requirement, option A is the best answer as written.
The designated person does not become responsible for paying premiums and does not assume liability for the applicant's care. The person's role is simply to receive notice, allowing the person an opportunity to alert the insured or help address an overlooked payment. Payroll or pension deduction is not a required payment method.
Before an individual long-term care policy can lapse for nonpayment, notice requirements apply to both the policyholder and the designated person. This is a key long-term-care consumer-protection provision.
Study Guide references/topics: long-term care insurance; lapse protection; nonpayment of premium; designation of another person; NAC 687B.0681 .

質問 # 90
A corporation purchases life insurance on a highly valuable executive and is named as owner, premium payer, and beneficiary. What is the primary purpose of this arrangement?

A. Family maintenance insurance
B. Credit life insurance
C. Viatical settlement insurance
D. Key person insurance

正解：D

解説：
Key person insurance is life insurance purchased by a business on the life of an employee, owner, executive, or specialist whose death would create a significant financial loss for the business. The business is generally the owner, premium payer, and beneficiary. If the key person dies, the death proceeds can help the business offset lost revenue, recruit and train a replacement, protect credit relationships, reassure customers, or meet other financial obligations during the transition.
The key person must consent to the insurance, and the business must have a legitimate insurable interest at the time coverage is issued. Key person insurance is not designed to provide personal family protection to the employee. It protects the business against the financial consequences of losing an important contributor.
Credit life insurance is designed to help pay an outstanding debt upon the debtor's death. Family maintenance insurance is generally personal coverage intended to replace income or support dependents. A viatical settlement involves the sale of an existing life insurance policy to a third party, typically when the insured has a serious illness.
The producer should conduct a financial-needs analysis and coordinate with legal and tax advisers because ownership, consent, accounting treatment, and tax consequences require careful planning.
References/topics from the Study Guide: Key Person Insurance; Business Uses of Life Insurance; Insurable Interest; Business Continuation Planning; Executive Protection.

質問 # 91
Basic cancer plans pay for all of the following EXCEPT:

A. immunotherapy
B. radiotherapy
C. physical therapy
D. chemotherapy

正解：C

解説：
Basic cancer policies are limited-benefit plans intended to supplement, rather than replace, comprehensive medical coverage. They commonly provide benefits for cancer-specific treatment such as chemotherapy, radiotherapy, and immunotherapy, subject to the policy's definitions, schedules, and limits. Therefore, choice C is correct because physical therapy is not ordinarily a core cancer-treatment benefit under a basic cancer policy. Physical therapy may be covered under a comprehensive medical plan or under a more expansive supplemental policy if expressly included, but it is not a standard basic cancer-plan benefit. Cancer policies can pay specified amounts for surgery, hospital confinement, physician services, diagnostic testing, drugs, radiation, chemotherapy, or other treatment tied directly to a covered cancer diagnosis. The insured should not assume that every medical expense arising during cancer treatment is covered. Benefits may be subject to waiting periods, preexisting-condition restrictions, recurrence rules, benefit schedules, and exclusions. The appropriate exam distinction is between benefits directly associated with treatment of cancer and general rehabilitative or medical services that are not expressly included in the cancer policy. Study Guide References
/Topics: Types of Health Insurance Policies; Limited-Coverage Health Policies; Cancer Insurance.

質問 # 92
A client needs a $250,000 death benefit for exactly 20 years to protect a home mortgage. The client wants the lowest practical initial premium and does not need cash-value accumulation. Which policy is most appropriate?

A. Variable life insurance
B. Universal life insurance
C. Whole life insurance
D. Level term life insurance

正解：D

解説：
Level term life insurance is the appropriate recommendation because it provides a stated death benefit for a stated period, such as 20 years. It is designed for temporary protection where the financial need has a known end date-for example, the remaining duration of a mortgage, a child's dependency period, or a short-to- medium-term income-replacement need. The premium is generally level for the selected term period, while the death benefit remains level if the policy stays in force.
Whole life insurance provides permanent protection and cash-value accumulation, but its premium is ordinarily higher because the insurer expects coverage to continue for the insured's lifetime. Universal life offers flexible premiums and adjustable death-benefit structures, but it is not the simplest match when the client's purpose is fixed, time-limited mortgage protection. Variable life has investment risk because policy values depend on separate-account performance and is not selected merely to obtain low-cost temporary coverage.
The producer should confirm that the term period aligns with the mortgage obligation and explain that coverage normally ends at the term's expiration unless the policy is renewed, converted, or otherwise continued under its provisions.
References/topics from the Study Guide: Types of Life Insurance; Term Life Insurance; Needs Analysis; Mortgage Protection.

質問 # 93
After appointing a producer as its agent, when must an insurer generally file its notice of appointment with the Nevada Commissioner?

A. Before the producer completes any insurance training
B. Within 15 days after the contract is executed or the first application is submitted
C. Only at the producer's next license renewal
D. Within 90 days after the first premium is collected

正解：B

解説：
In Nevada, an insurer appointing a producer as its agent must generally file a notice of appointment with the Commissioner within 15 days after the agency contract is executed or the first application for insurance is submitted, whichever event triggers the statutory timing. The appointment establishes the producer's authority to act as the insurer's agent for the applicable business. An agent is a producer compensated by the insurer who sells, solicits, or negotiates insurance for that insurer.
A producer who is not acting as an insurer's agent may act as a broker, subject to the statutory definition and applicable requirements. The distinction matters because an agent represents the insurer in the agency relationship, while a broker acts on behalf of the insured or prospective insured and lacks authority to bind an insurer through the broker's own actions.
The appointment requirement does not replace the producer-license requirement. Before selling, soliciting, or negotiating a class of insurance in Nevada, the person must hold the appropriate line of authority. A life or health producer must therefore have the relevant licensing authority and, when acting as an insurer's agent, be properly appointed.
Examination questions often test both the 15-day filing timeline and the difference between an agent and a broker.
References/topics from the Study Guide: Producer Appointments; Agent and Broker Distinction; Insurer Appointments; Nevada Producer Licensing; NRS 683A.321.

質問 # 94
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