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:

Section	Weight	Objectives
Topic 1: Nevada Statutes and Codes Common to Life, Health, Property, and Casualty Insurance	20%	- Insurance Commissioner 1. General powers and duties 2. Examinations 3. Notice and hearings and penalties - Nevada Life and Health Insurance Guaranty Association - Definitions 1. Certificate of authority 2. Insurer 3. Cost-sharing 4. Domestic, foreign, and alien 5. Transacting insurance 6. Premiums 7. Authorized and unauthorized - Marketing Practices 1. Commissions and payment restrictions 2. Required records and record retention 3. Fiduciary responsibilities 4. Silver State Health Insurance Exchange 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. Name of licensee 2. Renewal and continuing education 3. Persons required to be licensed 4. Obtaining a license 5. Suspension, revocation, and refusal of license 6. Termination of license
Topic 2: Accident & Health – General Knowledge	50%	- Social Insurance 1. Social Security benefits 2. Medicaid 3. Medicare Parts A, B, C, and D - Types of Policies 1. Disability income Individual disability income policy Business overhead expense policy Business disability buyout policy Group disability income policy Key employee policy 2. Medicare supplement policies 3. Group insurance Differences between individual and group contracts General characteristics COBRA 4. 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 5. Accidental death and dismemberment 6. Individual and Group Long Term Care Eligibility Levels of care 7. Other policies Dental Vision Cancer Critical illness or specified disease Worksite employer-sponsored Hospital indemnity Short-term medical Accident - Other Insurance Concepts 1. Owner's rights 2. Workers Compensation 3. Tax treatment of premiums and proceeds of insurance contracts 4. Cost containment 5. Subrogation 6. Total, partial, recurrent, and residual disability 7. Primary and contingent beneficiaries 8. Occupational vs. non-occupational 9. Dependent children benefits 10. Nonduplication and coordination of benefits 11. Modes of premium payments 12. Managed care - 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. Rights of renewability Noncancelable Cancelable Guaranteed renewable 3. Riders Impairment and exclusions Guaranteed insurability Future increase option 4. 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 - Field Underwriting Procedures 1. Explaining policy provisions, riders, exclusions, and ratings 2. Sources of insurability and HIPAA privacy information 3. Replacement 4. Completing the application 5. Contract law Elements of a contract Insurable interest Warranties and representations Unique aspects of the insurance contract 6. Submitting application and initial premium to company for underwriting 7. Initial premium payment and receipt 8. Policy delivery
Topic 3: Nevada Statutes and Codes Pertinent to Health Insurance Only	14%	- Long Term Care - Medicare 1. Medicare Advantage Plans 2. Medicare supplement regulation 3. Prescription Drug Plan - Coverage for reconstructive surgery - Availability of coverage for mental health and treatment of alcohol abuse and drug abuse - Mandatory policy clauses and provisions 1. Coverage for physical handicap or intellectual disability for dependent children 2. Coverage for newborn children 3. Coverage for preventive healthcare services - Hospice care
Topic 4: Nevada Statutes and Codes Common to Life and Health Insurance Only	4%	- Advertising - Group life and health insurance 1. Eligible groups 2. Required provisions - Credit life and health insurance

Insurance Licensing NV Accident and Health Sample Questions:

Question #1

A Long-Term Care policy provides coverage for:

A. hospital expenses
B. medical expenses
C. custodial care in a nursing home
D. Medicare Supplement coverage

Reveal Solution Discussion 0

Correct Answer: C 🗳️