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Insurance Licensing InsNV_Health02 Exam Syllabus Topics:

SectionObjectives
Topic 1: Government Health Insurance Programs- Medicare
  • 1. Medicare supplement insurance
    • 2. Medicare parts and eligibility
      - Medicaid and Other Programs
      • 1. Medicaid eligibility and coverage
        Topic 2: Health Insurance Policy Provisions- Mandatory and Optional Provisions
        • 1. Policy requirements and clauses
          • 2. Renewability provisions
            - Claims and Benefits
            • 1. Benefit determination and payment
              • 2. Claim procedures
                Topic 3: Producer Duties and Ethics- Ethical Responsibilities
                • 1. Consumer protection requirements
                  • 2. Fiduciary responsibilities
                    - Sales Practices
                    • 1. Advertising and marketing rules
                      • 2. Unfair trade practices
                        Topic 4: General Insurance Regulation- Licensing Requirements and Responsibilities
                        • 1. Producer licensing requirements
                          • 2. Continuing education and license maintenance
                            - Nevada Insurance Department and Regulatory Authority
                            • 1. Commissioner of Insurance powers and duties
                              • 2. Insurance laws, rules, and regulations
                                Topic 5: 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
                                        Topic 6: Accident and Health Insurance Fundamentals- Medical Expense Insurance
                                        • 1. Major medical plans
                                          • 2. Hospital, surgical, and physician expense coverage
                                            - Disability Income Insurance
                                            • 1. Disability definitions and benefits
                                              • 2. Elimination periods and benefit periods
                                                - Types of Health Insurance Policies
                                                • 1. Group health insurance
                                                  • 2. Managed care plans
                                                    • 3. Individual health insurance

                                                      Insurance Licensing NV Accident and Health Sample Questions:

                                                      1. Basic cancer plans pay for all of the following EXCEPT:

                                                      A) immunotherapy
                                                      B) chemotherapy
                                                      C) radiotherapy
                                                      D) physical therapy


                                                      2. One key distinction between producers and Exchange Enrollment Facilitator (EEF) is producers:

                                                      A) can recommend a health plan for a consumer
                                                      B) are compensated monetarily
                                                      C) can answer questions regarding program eligibility
                                                      D) can explain insurance terms like copayments and deductibles


                                                      3. J and K are married and have several children. J is the primary beneficiary on K ' s Accidental Death and Dismemberment (AD & D) policy, and K ' s sibling, L, is the contingent beneficiary. J, K, and L are involved in a train accident, and K and L are killed instantly. The Accidental Death benefits will be paid to:

                                                      A) J only
                                                      B) L ' s estate
                                                      C) K ' s estate
                                                      D) J and K ' s estate


                                                      4. Which of the following persons is NOT required to be licensed by the Nevada Insurance Commissioner?

                                                      A) An adjuster's employee who assists in the investigation and settlement of insurance claims
                                                      B) A salaried insurance agency clerk who also receives commissions on applications the clerk processes
                                                      C) A person who procures insurance for an insured
                                                      D) A salaried insurance company employee who performs clerical and administrative work


                                                      5. Under a typical coordination-of-benefits rule, a child is covered under both parents' group health plans.
                                                      Which plan is generally primary when the parents are married and neither plan contains an exception?

                                                      A) The plan that began most recently
                                                      B) The plan of the parent whose birthday falls earlier in the calendar year
                                                      C) The plan with the highest deductible
                                                      D) The plan selected by the child each year


                                                      Solutions:

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

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