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Insurance Licensing InsNV_Health02 Exam Overview:

Certification Vendor:Nevada Division of Insurance / Pearson VUE
Exam Name:NV Accident and Health
Exam Number:InsNV_Health02
Exam Format:Multiple choice, Computer-based examination, Two sections: General Knowledge and Nevada Specific
Exam Duration:135 minutes
Exam Price:USD 37
Real Exam Qty:98 (88 scored + 10 pretest)
Certificate Validity Period:The examination must be passed within 1 year before applying for the Nevada resident producer license; the Health producer license is subject to the applicable Nevada license renewal period.
Available Languages:English
Passing Score:70 scaled score
Related Certifications:Nevada Resident Insurance Producer License
Nevada Accident and Health Insurance Producer License
Sample Questions:Insurance Licensing InsNV_Health02 Sample Questions
Exam Way:Pearson VUE computer-based examination available at Pearson VUE test centers and through OnVUE online proctoring. Reservations should generally be made at least 24 hours in advance. The exam consists of 50 scored plus 5 pretest questions in the Accident & Health General Knowledge section and 38 scored plus 5 pretest questions in the Health Nevada Specific section.
Pre Condition:For a Nevada resident producer applying for the Health line of authority, the candidate must pass the corresponding Nevada Insurance Producer examination. Nevada currently states that prelicensing education is not required for individuals applying for a producer license, although applicants may choose to take a preparatory course. After passing, the license application must be submitted within one year. The Nevada Division of Insurance also requires applicable licensing application, fingerprinting, and background-check requirements.

Insurance Licensing InsNV_Health02 Exam Syllabus Topics:

SectionWeightObjectives
Topic 1: Accident & Health – General Knowledge50%- 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. 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
  • 3. Individual and Group Long Term Care
    • Eligibility
    • Levels of care
  • 4. Accidental death and dismemberment
    • 5. Other policies
      • Dental
      • Vision
      • Cancer
      • Critical illness or specified disease
      • Worksite employer-sponsored
      • Hospital indemnity
      • Short-term medical
      • Accident
    • 6. Medicare supplement policies
      • 7. Group insurance
        • Differences between individual and group contracts
        • General characteristics
        • COBRA
      - Policy Provisions, Clauses, and Riders
      • 1. Rights of renewability
        • Noncancelable
        • Cancelable
        • Guaranteed renewable
      • 2. 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
      • 3. 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
      • 4. Riders
        • Impairment and exclusions
        • Guaranteed insurability
        • Future increase option
      - Field Underwriting Procedures
      • 1. Submitting application and initial premium to company for underwriting
        • 2. Explaining policy provisions, riders, exclusions, and ratings
          • 3. Policy delivery
            • 4. Initial premium payment and receipt
              • 5. Completing the application
                • 6. Replacement
                  • 7. Sources of insurability and HIPAA privacy information
                    • 8. Contract law
                      • Elements of a contract
                      • Insurable interest
                      • Warranties and representations
                      • Unique aspects of the insurance contract
                    - Social Insurance
                    • 1. Medicaid
                      • 2. Medicare Parts A, B, C, and D
                        • 3. Social Security benefits
                          - Other Insurance Concepts
                          • 1. Primary and contingent beneficiaries
                            • 2. Owner's rights
                              • 3. Subrogation
                                • 4. Dependent children benefits
                                  • 5. Cost containment
                                    • 6. Workers Compensation
                                      • 7. Tax treatment of premiums and proceeds of insurance contracts
                                        • 8. Modes of premium payments
                                          • 9. Managed care
                                            • 10. Occupational vs. non-occupational
                                              • 11. Nonduplication and coordination of benefits
                                                • 12. Total, partial, recurrent, and residual disability
                                                  Topic 2: Nevada Statutes and Codes Common to Life and Health Insurance Only4%- Group life and health insurance
                                                  • 1. Required provisions
                                                    • 2. Eligible groups
                                                      - Credit life and health insurance
                                                      - Advertising
                                                      Topic 3: Nevada Statutes and Codes Pertinent to Health Insurance Only14%- Coverage for reconstructive surgery
                                                      - Mandatory policy clauses and provisions
                                                      • 1. Coverage for preventive healthcare services
                                                        • 2. Coverage for newborn children
                                                          • 3. Coverage for physical handicap or intellectual disability for dependent children
                                                            - Hospice care
                                                            - Availability of coverage for mental health and treatment of alcohol abuse and drug abuse
                                                            - Long Term Care
                                                            - Medicare
                                                            • 1. Prescription Drug Plan
                                                              • 2. Medicare supplement regulation
                                                                • 3. Medicare Advantage Plans
                                                                  Topic 4: Nevada Statutes and Codes Common to Life, Health, Property, and Casualty Insurance20%- Licensing
                                                                  • 1. Suspension, revocation, and refusal of license
                                                                    • 2. Obtaining a license
                                                                      • 3. Termination of license
                                                                        • 4. Renewal and continuing education
                                                                          • 5. Name of licensee
                                                                            • 6. Persons required to be licensed
                                                                              - Definitions
                                                                              • 1. Authorized and unauthorized
                                                                                • 2. Transacting insurance
                                                                                  • 3. Insurer
                                                                                    • 4. Domestic, foreign, and alien
                                                                                      • 5. Certificate of authority
                                                                                        • 6. Premiums
                                                                                          • 7. Cost-sharing
                                                                                            - Marketing Practices
                                                                                            • 1. Commissions and payment restrictions
                                                                                              • 2. Required records and record retention
                                                                                                • 3. Affordable Care Act
                                                                                                  • 4. Silver State Health Insurance Exchange
                                                                                                    • 5. Fiduciary responsibilities
                                                                                                      • 6. Unfair practices
                                                                                                        • Unfair claims methods and practices and settlement of claims
                                                                                                        • Rebating and inducement
                                                                                                        • Twisting
                                                                                                        • Misrepresentation
                                                                                                        • Fraud
                                                                                                        • Unfair discrimination
                                                                                                        • Defamation
                                                                                                      - Insurance Commissioner
                                                                                                      • 1. General powers and duties
                                                                                                        • 2. Examinations
                                                                                                          • 3. Notice and hearings and penalties
                                                                                                            - Nevada Life and Health Insurance Guaranty Association

                                                                                                            Insurance Licensing NV Accident and Health Sample Questions:

                                                                                                            1. Which Medicare part generally helps cover inpatient hospital care, skilled nursing facility care following a qualifying hospital stay, hospice care, and certain home health services?

                                                                                                            A) Medicare Part D
                                                                                                            B) Medicare Part A
                                                                                                            C) Medicare Part B
                                                                                                            D) Medicare Part C


                                                                                                            2. In a disability income policy, the elimination period is best described as:

                                                                                                            A) The waiting period after disability begins before benefits become payable
                                                                                                            B) The maximum period for which premiums are waived
                                                                                                            C) The period during which the policy cannot be cancelled
                                                                                                            D) The period after disability during which benefits are payable


                                                                                                            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) An advertisement used during the sale
                                                                                                            B) A verbal statement made by the applicant
                                                                                                            C) A producer's personal notes
                                                                                                            D) The application


                                                                                                            4. A corporation purchases life insurance on a highly valuable executive and is named as owner, premium payer, and beneficiary. What is the primary purpose of this arrangement?

                                                                                                            A) Key person insurance
                                                                                                            B) Credit life insurance
                                                                                                            C) Viatical settlement insurance
                                                                                                            D) Family maintenance insurance


                                                                                                            5. Group health policies MUST provide which of the following benefits?

                                                                                                            A) Cosmetic surgery
                                                                                                            B) Adult dental care
                                                                                                            C) Hospice care
                                                                                                            D) Adult vision care


                                                                                                            Solutions:

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

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