Exam Code: InsNV_Health02
Exam Name: NV Accident and Health
Certification Provider: Insurance Licensing
Corresponding Certification: Nevada Insurance
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Insurance Licensing InsNV_Health02 Exam Syllabus Topics:

SectionObjectives
Health Insurance Policy Provisions- Mandatory and Optional Provisions
  • 1. Policy requirements and clauses
    • 2. Renewability provisions
      - Claims and Benefits
      • 1. Claim procedures
        • 2. Benefit determination and payment
          Accident and Health Insurance Fundamentals- Disability Income Insurance
          • 1. Disability definitions and benefits
            • 2. Elimination periods and benefit periods
              - Medical Expense Insurance
              • 1. Major medical plans
                • 2. Hospital, surgical, and physician expense coverage
                  - Types of Health Insurance Policies
                  • 1. Group health insurance
                    • 2. Individual health insurance
                      • 3. Managed care plans
                        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
                                Government Health Insurance Programs- Medicaid and Other Programs
                                • 1. Medicaid eligibility and coverage
                                  - Medicare
                                  • 1. Medicare parts and eligibility
                                    • 2. Medicare supplement insurance
                                      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
                                              Producer Duties and Ethics- Ethical Responsibilities
                                              • 1. Consumer protection requirements
                                                • 2. Fiduciary responsibilities
                                                  - Sales Practices
                                                  • 1. Advertising and marketing rules
                                                    • 2. Unfair trade practices

                                                      Insurance Licensing NV Accident and Health Sample Questions:

                                                      1. A producer who makes misleading policy comparisons for the purpose of inducing an insured to surrender an existing policy is guilty of:

                                                      A) coercion
                                                      B) twisting
                                                      C) rebating
                                                      D) defamation


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

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


                                                      3. The maximum cost share for preventive screening from an in-network provider is:

                                                      A) 20%
                                                      B) 10%
                                                      C) 30%
                                                      D) 0%


                                                      4. Which of the following organizations is the BEST example of a mutual insurance company?

                                                      A) An incorporated insurance company that has no capital stock and has a governing body that is elected by its policyholders
                                                      B) An unincorporated insurance company that operates through an attorney-in-fact common to all persons
                                                      C) An incorporated insurance company that has its capital divided into shares and is owned by stockholders
                                                      D) An unincorporated aggregation of subscribers who operate individually


                                                      5. In Nevada, a producer or examining physician who knowingly and willfully makes a false statement on an application for insurance may be guilty of:

                                                      A) fraud
                                                      B) coercion
                                                      C) twisting
                                                      D) misrepresentation


                                                      Solutions:

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

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