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Insurance Licensing InsNV_Health02 Exam Syllabus Topics:

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

                                                      Insurance Licensing NV Accident and Health Sample Questions:

                                                      1. Which rider allows a terminally ill insured to receive part of the death benefit while still alive, subject to the policy terms?

                                                      A) Accidental death rider
                                                      B) Accelerated death benefit rider
                                                      C) Payor benefit rider
                                                      D) Guaranteed insurability rider


                                                      2. A policy pays a stated dollar amount for each day an insured is confined to a hospital, regardless of the actual hospital bill. What type of coverage is this?

                                                      A) Comprehensive dental insurance
                                                      B) Major medical insurance
                                                      C) Disability buy-sell insurance
                                                      D) Hospital indemnity insurance


                                                      3. An individual health insurance policy contains a Change of Occupation provision. If the insured experiences a loss in a more hazardous occupation than when the policy was issued, the insurance company may:

                                                      A) adjust benefits to the amount the premium provides for the new occupation
                                                      B) increase the deductible to adjust for the occupational difference
                                                      C) increase the waiting period to adjust for the occupational difference
                                                      D) deny any claim on the basis of misrepresentation


                                                      4. For Social Security disability benefits, which statement is generally correct?

                                                      A) The program is funded entirely by private insurance premiums.
                                                      B) Benefits are available only to persons age 65 or older.
                                                      C) Benefits are payable for any short-term illness that prevents work for one week.
                                                      D) The program uses a strict definition of disability involving inability to perform substantial work for a required duration.


                                                      5. According to Nevada law, an authorized insurer is BEST defined as:

                                                      A) any insurer with minimum assets as required by this state
                                                      B) an insurer with a certificate of authority issued by the National Association of Insurance Commissioners (NAIC)
                                                      C) an insurer authorized under a certificate of authority issued by the Governor of Nevada
                                                      D) an insurer with a certificate of authority issued by the Insurance Commissioner of Nevada


                                                      Solutions:

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

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