Insurance Licensing InsNV_Health02 : NV Accident and Health

  • Exam Code: InsNV_Health02
  • Exam Name: NV Accident and Health
  • Updated: Aug 14, 2026
  • Q & A: 132 Questions and Answers

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Insurance Licensing InsNV_Health02 Exam Syllabus Topics:

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

                                                                                                            Insurance Licensing NV Accident and Health Sample Questions:

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

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


                                                                                                            2. A group health policy that covers hospital expenses MUST also cover:

                                                                                                            A) elective cosmetic surgery
                                                                                                            B) travel expenses for caretakers
                                                                                                            C) routine physical examinations
                                                                                                            D) burial expenses


                                                                                                            3. Under a group health policy, which of the following coverages MUST be provided for newborn children?

                                                                                                            A) Genetic Testing
                                                                                                            B) Congenital health defects
                                                                                                            C) Routine eye examinations
                                                                                                            D) Transportation costs from the hospital to the child ' s residence


                                                                                                            4. The Misstatement of Age provision in an Accident and Health policy allows an insurance company to take which of the following actions if an insured has understated the insured ' s age on the policy application?

                                                                                                            A) Cancel the policy
                                                                                                            B) Adjust the benefits
                                                                                                            C) Increase the premium
                                                                                                            D) Lapse the coverage


                                                                                                            5. A policyowner borrows money from the insurer using the cash value of a whole life policy as security. If the loan and accrued interest are unpaid when the insured dies, what is the usual result?

                                                                                                            A) The beneficiary receives the full death benefit and the loan is forgiven.
                                                                                                            B) The cash value is transferred automatically to the beneficiary instead of the death benefit.
                                                                                                            C) The insurer cancels the policy immediately when the loan is made.
                                                                                                            D) The death benefit is reduced by the outstanding loan and interest.


                                                                                                            Solutions:

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

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