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Insurance Licensing InsNV_Health02 Exam Overview:

Certification Vendor:Nevada Division of Insurance / Pearson VUE
Exam Name:NV Accident and Health
Exam Number:InsNV_Health02
Exam Price:USD 37
Exam Format:Computer-based examination, Two sections: General Knowledge and Nevada Specific, Multiple choice
Available Languages:English
Passing Score:70 scaled score
Real Exam Qty:98 (88 scored + 10 pretest)
Certificate Validity Period:The examination must be passed within 1 year before applying for the Nevada resident producer license; the Health producer license is subject to the applicable Nevada license renewal period.
Exam Duration:135 minutes
Related Certifications:Nevada Resident Insurance Producer License
Nevada Accident and Health Insurance Producer License
Sample Questions:Insurance Licensing InsNV_Health02 Sample Questions
Exam Way:Pearson VUE computer-based examination available at Pearson VUE test centers and through OnVUE online proctoring. Reservations should generally be made at least 24 hours in advance. The exam consists of 50 scored plus 5 pretest questions in the Accident & Health General Knowledge section and 38 scored plus 5 pretest questions in the Health Nevada Specific section.
Pre Condition:For a Nevada resident producer applying for the Health line of authority, the candidate must pass the corresponding Nevada Insurance Producer examination. Nevada currently states that prelicensing education is not required for individuals applying for a producer license, although applicants may choose to take a preparatory course. After passing, the license application must be submitted within one year. The Nevada Division of Insurance also requires applicable licensing application, fingerprinting, and background-check requirements.

Insurance Licensing InsNV_Health02 Exam Syllabus Topics:

SectionWeightObjectives
Topic 1: Accident & Health – General Knowledge50%- Types of Policies
  • 1. Accidental death and dismemberment
    • 2. Disability income
      • Individual disability income policy
      • Business overhead expense policy
      • Business disability buyout policy
      • Group disability income policy
      • Key employee policy
    • 3. Medicare supplement policies
      • 4. Individual and Group Long Term Care
        • Eligibility
        • Levels of care
      • 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. 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
      - Field Underwriting Procedures
      • 1. Sources of insurability and HIPAA privacy information
        • 2. Contract law
          • Elements of a contract
          • Insurable interest
          • Warranties and representations
          • Unique aspects of the insurance contract
        • 3. Submitting application and initial premium to company for underwriting
          • 4. Replacement
            • 5. Policy delivery
              • 6. Initial premium payment and receipt
                • 7. Explaining policy provisions, riders, exclusions, and ratings
                  • 8. Completing the application
                    - Social Insurance
                    • 1. Social Security benefits
                      • 2. Medicaid
                        • 3. Medicare Parts A, B, C, and D
                          - Policy Provisions, Clauses, and Riders
                          • 1. Rights of renewability
                            • Noncancelable
                            • Cancelable
                            • Guaranteed renewable
                          • 2. 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
                          • 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. Riders
                            • Impairment and exclusions
                            • Guaranteed insurability
                            • Future increase option
                          - Other Insurance Concepts
                          • 1. Total, partial, recurrent, and residual disability
                            • 2. Modes of premium payments
                              • 3. Managed care
                                • 4. Owner's rights
                                  • 5. Workers Compensation
                                    • 6. Dependent children benefits
                                      • 7. Subrogation
                                        • 8. Tax treatment of premiums and proceeds of insurance contracts
                                          • 9. Occupational vs. non-occupational
                                            • 10. Primary and contingent beneficiaries
                                              • 11. Cost containment
                                                • 12. Nonduplication and coordination of benefits
                                                  Topic 2: Nevada Statutes and Codes Common to Life and Health Insurance Only4%- Group life and health insurance
                                                  • 1. Eligible groups
                                                    • 2. Required provisions
                                                      - Advertising
                                                      - Credit life and health insurance
                                                      Topic 3: Nevada Statutes and Codes Common to Life, Health, Property, and Casualty Insurance20%- Licensing
                                                      • 1. Suspension, revocation, and refusal of license
                                                        • 2. Termination of license
                                                          • 3. Renewal and continuing education
                                                            • 4. Obtaining a license
                                                              • 5. Persons required to be licensed
                                                                • 6. Name of licensee
                                                                  - Nevada Life and Health Insurance Guaranty Association
                                                                  - Definitions
                                                                  • 1. Cost-sharing
                                                                    • 2. Domestic, foreign, and alien
                                                                      • 3. Authorized and unauthorized
                                                                        • 4. Premiums
                                                                          • 5. Certificate of authority
                                                                            • 6. Insurer
                                                                              • 7. Transacting insurance
                                                                                - Insurance Commissioner
                                                                                • 1. Examinations
                                                                                  • 2. General powers and duties
                                                                                    • 3. Notice and hearings and penalties
                                                                                      - Marketing Practices
                                                                                      • 1. Unfair practices
                                                                                        • Unfair claims methods and practices and settlement of claims
                                                                                        • Rebating and inducement
                                                                                        • Twisting
                                                                                        • Misrepresentation
                                                                                        • Fraud
                                                                                        • Unfair discrimination
                                                                                        • Defamation
                                                                                      • 2. Fiduciary responsibilities
                                                                                        • 3. Affordable Care Act
                                                                                          • 4. Silver State Health Insurance Exchange
                                                                                            • 5. Commissions and payment restrictions
                                                                                              • 6. Required records and record retention
                                                                                                Topic 4: Nevada Statutes and Codes Pertinent to Health Insurance Only14%- Medicare
                                                                                                • 1. Medicare supplement regulation
                                                                                                  • 2. Medicare Advantage Plans
                                                                                                    • 3. Prescription Drug Plan
                                                                                                      - Mandatory policy clauses and provisions
                                                                                                      • 1. Coverage for newborn children
                                                                                                        • 2. Coverage for physical handicap or intellectual disability for dependent children
                                                                                                          • 3. Coverage for preventive healthcare services
                                                                                                            - Hospice care
                                                                                                            - Long Term Care
                                                                                                            - Coverage for reconstructive surgery
                                                                                                            - Availability of coverage for mental health and treatment of alcohol abuse and drug abuse

                                                                                                            Insurance Licensing NV Accident and Health Sample Questions:

                                                                                                            Question 1

                                                                                                            The maximum cost share for preventive screening from an in-network provider is:

                                                                                                            A. 20%
                                                                                                            B. 0%
                                                                                                            C. 10%
                                                                                                            D. 30%


                                                                                                            Question 2

                                                                                                            The Affordable Care Act (ACA) requires every individual policy to provide minimum coverages known as:

                                                                                                            A. Gold Value coverages
                                                                                                            B. Medicaid Buy-Back coverage
                                                                                                            C. Essential Health Benefits
                                                                                                            D. Silver Saver Value coverages


                                                                                                            Question 3

                                                                                                            An applicant unintentionally gives an incorrect answer about a material health condition on a life insurance application. This is best described as:

                                                                                                            A. A rider
                                                                                                            B. A premium-payment mode
                                                                                                            C. A warranty that automatically voids the policy
                                                                                                            D. A representation that may be material to underwriting


                                                                                                            Question 4

                                                                                                            As a condition to granting a loan, a creditor can:

                                                                                                            A. assess a higher interest rate if insurance is not purchased
                                                                                                            B. require insurance in an amount greater than the debt
                                                                                                            C. require insurance coverage through a specific insurer
                                                                                                            D. accept assignment from an existing policy


                                                                                                            Question 5

                                                                                                            A Major Medical policy insured is injured in an auto collision during a police chase. The occupants in the police car are killed. The insured is convicted of reckless driving and manslaughter. If the insured files a claim, the insurance company will MOST likely take which of the following actions?

                                                                                                            A. Deny the claim and return the premiums paid
                                                                                                            B. Pay full benefits
                                                                                                            C. Deny the claim only
                                                                                                            D. Pay partial benefits


                                                                                                            Solutions:

                                                                                                            Question 1
                                                                                                            Answer: B
                                                                                                            Question 2
                                                                                                            Answer: C
                                                                                                            Question 3
                                                                                                            Answer: D
                                                                                                            Question 4
                                                                                                            Answer: D
                                                                                                            Question 5
                                                                                                            Answer: B

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