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

Insurance Licensing NV Accident and Health Sample Questions:

Question #1

In a cross-purchase buy-sell agreement funded by life insurance, who typically owns the policy on each business owner?

A. The insured owner's children own the policy.
B. Each owner owns policies on the other owners.
C. The producer owns the policy until death occurs.
D. The business entity owns every policy.

Reveal Solution Discussion 0

Correct Answer: B 🗳️