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Insurance Licensing InsNV_Health02 Exam Syllabus Topics:

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

                                                      Insurance Licensing NV Accident and Health Sample Questions:

                                                      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) Rebating
                                                      B) Subrogation
                                                      C) Assignment
                                                      D) Coinsurance


                                                      2. Under the Guaranteed Renewable provision in a policy issued to a group of persons having a common occupation, an insurance company may NOT terminate coverage on a group member if the member:

                                                      A) ceases to fall within the eligible classification
                                                      B) ceases to be actively employed
                                                      C) becomes disabled
                                                      D) reaches the age specified in the policy


                                                      3. An insurer shall not issue an individual long-term care insurance contract in Nevada unless the insurer has received from the applicant:

                                                      A) a written designation of at least one person, in addition to the applicant, who must receive notice of any lapse or termination of coverage under the policy for nonpayment of premium
                                                      B) a written designation by the applicant to pay premium for long-term care insurance through either a payroll or pension deduction plan
                                                      C) a notarized waiver dated and signed by the applicant stating that the applicant has chosen not to designate another person to receive notice of any lapse or termination of coverage for nonpayment of premium
                                                      D) a designation by at least one person, in addition to the applicant, to accept liability for services provided to the applicant


                                                      4. When a criminal violation of the insurance code has occurred, the Nevada Insurance Commissioner is required to report the violation to the:

                                                      A) Lieutenant Governor
                                                      B) Secretary of State
                                                      C) State Police
                                                      D) District Attorney


                                                      5. Under a group health policy, which of the following coverages MUST be provided for newborn children?

                                                      A) Congenital health defects
                                                      B) Routine eye examinations
                                                      C) Genetic Testing
                                                      D) Transportation costs from the hospital to the child ' s residence


                                                      Solutions:

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

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