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Insurance Licensing InsNV_Health02 Exam Syllabus Topics:

SectionObjectives
Accident and Health Insurance Fundamentals- Types of Health Insurance Policies
  • 1. Group health insurance
    • 2. Individual health insurance
      • 3. Managed care plans
        - Disability Income Insurance
        • 1. Disability definitions and benefits
          • 2. Elimination periods and benefit periods
            - Medical Expense Insurance
            • 1. Hospital, surgical, and physician expense coverage
              • 2. Major medical plans
                Government Health Insurance Programs- Medicaid and Other Programs
                • 1. Medicaid eligibility and coverage
                  - Medicare
                  • 1. Medicare parts and eligibility
                    • 2. Medicare supplement insurance
                      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
                              Producer Duties and Ethics- Ethical Responsibilities
                              • 1. Consumer protection requirements
                                • 2. Fiduciary responsibilities
                                  - Sales Practices
                                  • 1. Unfair trade practices
                                    • 2. Advertising and marketing rules
                                      Insurance Basics- Insurance Contracts
                                      • 1. Policy provisions, riders, and exclusions
                                        • 2. Contract elements
                                          - Risk Management and Insurance Concepts
                                          • 1. Insurance principles and contract characteristics
                                            • 2. Types of risk and methods of handling risk
                                              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

                                                      Insurance Licensing NV Accident and Health Sample Questions:

                                                      1. Which of the following statements is generally CORRECT about a major medical policy?

                                                      A) It provides benefits for in-hospital expenses only, subject to policy limits.
                                                      B) It provides benefits for reasonable and necessary medical expenses, subject to policy limits.
                                                      C) It contains more limitations than a Basic Hospital, Medical, or Surgical policy.
                                                      D) It contains a 30-day Elimination period for losses due to sickness.


                                                      2. An employee's group life coverage terminates because employment ends. During the applicable conversion period, the former employee dies before applying for an individual policy. What protection does Nevada group-life law provide?

                                                      A) The amount that could have been converted is payable under the group policy.
                                                      B) The employer must personally pay the former employee's beneficiary.
                                                      C) No benefit is payable because the employee did not submit an application.
                                                      D) Only any accumulated cash value is payable.


                                                      3. Under an Accidental Death and Dismemberment policy, in which of the following circumstances will an autopsy NOT be performed?

                                                      A) When the beneficiary refuses to give consent
                                                      B) When it is prohibited by law
                                                      C) When the cause of death was an accident
                                                      D) When the cause of death was an illness


                                                      4. 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) Level term life insurance
                                                      C) Whole life insurance
                                                      D) Universal life insurance


                                                      5. Under the Affordable Care Act (ACA), for a woman 40 years or older, mammograms are:

                                                      A) not covered if a family member has been formally diagnosed with breast cancer
                                                      B) not covered under the rules of ACA because mammograms are not considered preventative health care
                                                      C) covered under preventative services annually at no cost
                                                      D) covered under only health plans that offer mammogram coverage


                                                      Solutions:

                                                      Question # 1
                                                      Answer: B
                                                      Question # 2
                                                      Answer: A
                                                      Question # 3
                                                      Answer: B
                                                      Question # 4
                                                      Answer: B
                                                      Question # 5
                                                      Answer: C

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