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Insurance Licensing InsNV_Health02 Exam Syllabus Topics:
| Section | Weight | Objectives |
| Accident & Health – General Knowledge | 50% | - Types of Policies
- 1. Accidental death and dismemberment
- 2. Individual and Group Long Term Care
- Eligibility
- Levels of care
- 3. 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
- 4. Other policies
- Dental
- Vision
- Cancer
- Critical illness or specified disease
- Worksite employer-sponsored
- Hospital indemnity
- Short-term medical
- Accident
- 5. Disability income
- Individual disability income policy
- Business overhead expense policy
- Business disability buyout policy
- Group disability income policy
- Key employee policy
- 6. Group insurance
- Differences between individual and group contracts
- General characteristics
- COBRA
- 7. Medicare supplement policies
- Social Insurance
- 1. Social Security benefits
- 2. Medicaid
- 3. Medicare Parts A, B, C, and D
- Other Insurance Concepts
- 1. Tax treatment of premiums and proceeds of insurance contracts
- 2. Subrogation
- 3. Total, partial, recurrent, and residual disability
- 4. Primary and contingent beneficiaries
- 5. Nonduplication and coordination of benefits
- 6. Cost containment
- 7. Managed care
- 8. Workers Compensation
- 9. Owner's rights
- 10. Occupational vs. non-occupational
- 11. Modes of premium payments
- 12. Dependent children benefits
- Field Underwriting Procedures
- 1. Policy delivery
- 2. Initial premium payment and receipt
- 3. Explaining policy provisions, riders, exclusions, and ratings
- 4. Contract law
- Elements of a contract
- Insurable interest
- Warranties and representations
- Unique aspects of the insurance contract
- 5. Sources of insurability and HIPAA privacy information
- 6. Submitting application and initial premium to company for underwriting
- 7. Replacement
- 8. Completing the application
- Policy Provisions, Clauses, and Riders
- 1. 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
- 2. 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
- 3. Rights of renewability
- Noncancelable
- Cancelable
- Guaranteed renewable
- 4. Riders
- Impairment and exclusions
- Guaranteed insurability
- Future increase option
|
| Nevada Statutes and Codes Common to Life and Health Insurance Only | 4% | - Group life and health insurance
- 1. Eligible groups
- 2. Required provisions
- Advertising
- Credit life and health insurance
|
| Nevada Statutes and Codes Pertinent to Health Insurance Only | 14% | - Hospice care
- Coverage for reconstructive surgery
- 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
- Medicare
- 1. Medicare supplement regulation
- 2. Prescription Drug Plan
- 3. Medicare Advantage Plans
- Availability of coverage for mental health and treatment of alcohol abuse and drug abuse
- Long Term Care
|
| Nevada Statutes and Codes Common to Life, Health, Property, and Casualty Insurance | 20% | - Nevada Life and Health Insurance Guaranty Association
- Marketing Practices
- 1. Silver State Health Insurance Exchange
- 2. Fiduciary responsibilities
- 3. Commissions and payment restrictions
- 4. Required records and record retention
- 5. Unfair practices
- Unfair claims methods and practices and settlement of claims
- Rebating and inducement
- Twisting
- Misrepresentation
- Fraud
- Unfair discrimination
- Defamation
- 6. Affordable Care Act
- Licensing
- 1. Renewal and continuing education
- 2. Name of licensee
- 3. Suspension, revocation, and refusal of license
- 4. Persons required to be licensed
- 5. Obtaining a license
- 6. Termination of license
- Insurance Commissioner
- 1. Notice and hearings and penalties
- 2. General powers and duties
- 3. Examinations
- Definitions
- 1. Domestic, foreign, and alien
- 2. Insurer
- 3. Authorized and unauthorized
- 4. Cost-sharing
- 5. Certificate of authority
- 6. Transacting insurance
- 7. Premiums
|
Insurance Licensing NV Accident and Health Sample Questions:
Question 1
What is the principal purpose of Medicare supplement insurance?
A. To replace Medicare Part A and Part B entirely
B. To help pay certain deductibles, coinsurance, and other gaps in Original Medicare
C. To provide Medicaid eligibility
D. To pay only long-term custodial care
Question 2
Which of the following statements is CORRECT about the Medicaid program?
A. The program is administered at the federal level.
B. It is supplemented by Medicare for persons 62 years of age or older.
C. It provides medical assistance for participants who are blind.
D. Participants must be at least 55 years of age.
Question 3
For an individual health insurance policy, which document is generally part of the entire contract when a copy is attached to or endorsed on the policy?
A. A producer's personal notes
B. A verbal statement made by the applicant
C. The application
D. An advertisement used during the sale
Question 4
Which of the following persons is NOT required to be licensed by the Nevada Insurance Commissioner?
A. A person who procures insurance for an insured
B. A salaried insurance company employee who performs clerical and administrative work
C. A salaried insurance agency clerk who also receives commissions on applications the clerk processes
D. An adjuster's employee who assists in the investigation and settlement of insurance claims
Question 5
What is the primary purpose of a waiver-of-premium rider on a life insurance policy?
A. It waives required premiums if the insured becomes totally disabled as defined by the rider.
B. It converts term insurance automatically into whole life insurance.
C. It eliminates all future policy loans.
D. It guarantees a higher death benefit every year.
Solutions:
Question 1 Answer: B | Question 2 Answer: C | Question 3 Answer: C | Question 4 Answer: B | Question 5 Answer: A |