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Insurance Licensing InsNV_Health02 Exam Syllabus Topics:

SectionObjectives
Accident and Health Insurance Fundamentals- Types of Health Insurance Policies
  • 1. Individual health insurance
    • 2. Managed care plans
      • 3. Group health insurance
        - Medical Expense Insurance
        • 1. Hospital, surgical, and physician expense coverage
          • 2. Major medical plans
            - Disability Income Insurance
            • 1. Disability definitions and benefits
              • 2. Elimination periods and benefit periods
                Health Insurance Policy Provisions- Mandatory and Optional Provisions
                • 1. Renewability provisions
                  • 2. Policy requirements and clauses
                    - Claims and Benefits
                    • 1. Claim procedures
                      • 2. Benefit determination and payment
                        General Insurance Regulation- Licensing Requirements and Responsibilities
                        • 1. Producer licensing requirements
                          • 2. Continuing education and license maintenance
                            - Nevada Insurance Department and Regulatory Authority
                            • 1. Commissioner of Insurance powers and duties
                              • 2. Insurance laws, rules, and regulations
                                Insurance Basics- Risk Management and Insurance Concepts
                                • 1. Insurance principles and contract characteristics
                                  • 2. Types of risk and methods of handling risk
                                    - Insurance Contracts
                                    • 1. Policy provisions, riders, and exclusions
                                      • 2. Contract elements
                                        Government Health Insurance Programs- Medicare
                                        • 1. Medicare parts and eligibility
                                          • 2. Medicare supplement insurance
                                            - Medicaid and Other Programs
                                            • 1. Medicaid eligibility and coverage
                                              Producer Duties and Ethics- Ethical Responsibilities
                                              • 1. Fiduciary responsibilities
                                                • 2. Consumer protection requirements
                                                  - Sales Practices
                                                  • 1. Unfair trade practices
                                                    • 2. Advertising and marketing rules

                                                      Insurance Licensing NV Accident and Health Sample Questions:

                                                      Question 1

                                                      A producer offers a prospective life insurance applicant a gift card that is not stated in the policy as an inducement to purchase coverage. Which prohibited practice is most directly implicated?

                                                      A. Subrogation
                                                      B. Assignment
                                                      C. Rebating
                                                      D. Coinsurance


                                                      Question 2

                                                      Which policy is designed to pay benefits upon diagnosis or treatment of a specifically named illness, such as cancer?

                                                      A. Credit disability insurance
                                                      B. Specified disease insurance
                                                      C. Major medical insurance
                                                      D. Group term life insurance


                                                      Question 3

                                                      In Nevada, which life insurance policy is subject to a 30-day right to surrender for a premium refund after delivery?

                                                      A. A group life certificate
                                                      B. A standard nonreplacement life insurance policy
                                                      C. An industrial life policy
                                                      D. A replacement life insurance policy


                                                      Question 4

                                                      Under an individual Major Medical policy, a married policyowner has the right to take which of the following actions?

                                                      A. Demand binding arbitration if there is disagreement over a claim
                                                      B. Add a newborn child to the policy without providing proof of insurability
                                                      C. Reinstate the policy within 3 years after it lapses
                                                      D. Sue the insurance company for not paying a claim within 30 days after submission of Proof of Loss


                                                      Question 5

                                                      If coverage has stayed in force with the same insurance company, what is the maximum number of years for which reconstructive surgery (mastectomy) benefits must be provided?

                                                      A. 5
                                                      B. 3
                                                      C. 1
                                                      D. 7


                                                      Solutions:

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

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