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

Group vision insurance plans typically provide insurance benefits that cover the cost of:

A. eye exams, lenses, frames, and contact lenses
B. laser surgery, eye exams, lenses
C. eye exams, lenses, retinal corrective surgery
D. cataract removal, frames, lenses

Reveal Solution Discussion 0

Correct Answer: A 🗳️