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 Overview:

Certification Vendor:	Nevada Division of Insurance / Pearson VUE
Exam Name:	NV Accident and Health
Exam Number:	InsNV_Health02
Available Languages:	English
Passing Score:	70 scaled score
Exam Format:	Multiple choice, Computer-based examination, Two sections: General Knowledge and Nevada Specific
Real Exam Qty:	98 (88 scored + 10 pretest)
Related Certifications:	Nevada Resident Insurance Producer License Nevada Accident and Health Insurance Producer License
Exam Duration:	135 minutes
Exam Price:	USD 37
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.
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:

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

Insurance Licensing NV Accident and Health Sample Questions:

1. Which of the following BEST describes Medicare Advantage Plans?

A) Privately subsidized government insurance
B) Federally funded welfare benefit plans
C) Government Subsidized private insurance
D) Long-Term care benefits rider added to basic Medicare benefits

2. Which of the following characteristics is typical of group insurance?

A) Each employee receives an individual contract.
B) Medical examinations are required.
C) All full-time employees are eligible for coverage.
D) Employees may automatically enroll for coverage at any time.

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

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

4. Under an individual health policy issued in Nevada, a newborn is automatically covered for a MAXIMUM of how many days after birth?

A) Ten
B) Two
C) Five
D) Thirty-one

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

Solutions:

Question # 1
Answer: C

Question # 2
Answer: C

Question # 3
Answer: B

Question # 4
Answer: D

Question # 5
Answer: D

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