ESTUDYR
2025 NV HEALTH UPDATED EXAM WITH MOST TESTED
QUESTIONS AND ANSWERS | GRADED A+ | ASSURED
SUCCESS WITH DETAILED RATIONALES
1. Which law requires the applicant to be notified before a consumer report is ordered?
A. Fair Labor Standards Act
B. Privacy Protection Act
C. Fair Credit Reporting Act
D. Equal Credit Opportunity Act
Correct Answer: C. Fair Credit Reporting Act
Rationale: The Fair Credit Reporting Act ensures that individuals are notified before a consumer report
is obtained, providing them with the opportunity to dispute any inaccuracies.
2. The Insuring Clause of an A&H policy usually states all of the following EXCEPT:
A. That insurance against loss is provided
B. That a loss must result directly from stated accidents or sicknesses
C. The method of premium payment
D. The identities of the insurance company and the insured
Correct Answer: C. The method of premium payment
Rationale: The Insuring Clause outlines the insurer's promise to pay benefits under certain conditions
but does not specify how premiums are paid.
3. Which of the following statements about Medicare is/are true?
I. Payments are made directly to the hospital providing services rather than to the insured
II. Benefits can continue beyond the hospitalization period
A. I only
B. II only
C. Both I and II
D. Neither I nor II
Correct Answer: C. Both I and II
Rationale: Medicare payments are made directly to providers, and benefits can extend beyond the
hospitalization period through additional coverage like skilled nursing and home health care.
,ESTUDYR
4. The Misstatement of Age provision gives the insurance company the right to:
A. Bring suit for fraud
B. Cancel the contract
C. Adjust benefits payable
D. Reduce dividends payable
Correct Answer: C. Adjust benefits payable
Rationale: The Misstatement of Age provision adjusts benefits or premiums to align with the insured's
correct age, maintaining actuarial fairness.
5. Which of the following statements about group A&H provisions and practices is/are true?
I. Insurance company practices are generally less liberal under Group policies than under Individual
policies
II. Experience rating is generally utilized under Group policies
A. I only
B. II only
C. Both I and II
D. Neither I nor II
Correct Answer: B. II only
Rationale: Group policies often use experience rating to determine premiums based on the claims
history of the group, whereas individual policies focus on the specific applicant's health.
6. A&H insurance provides coverage for sickness and injury that includes which of the following
benefits?
I. Income benefits due to loss of time from work
II. Benefit payments for hospital care
A. I only
B. II only
C. Both I and II
D. Neither I nor II
Correct Answer: C. Both I and II
Rationale: A&H insurance covers both disability income (loss of work) and medical expenses like
hospital care.
, ESTUDYR
7. The part of an HMO policy, which provides for the claim to be shared between the insurer and the
insured, is known as:
A. Deductible
B. Out-of-pocket maximum
C. Co-pay
D. Usual, Customary, and Reasonable
Correct Answer: C. Co-pay
Rationale: A co-pay is a fixed amount paid by the insured for specific services, with the insurer covering
the remaining cost.
8. Answers given by applicants to questions on applications for A&H insurance are considered which
of the following?
I. Representations
II. Warranties
A. I only
B. II only
C. Both I and II
D. Neither I nor II
Correct Answer: A. I only
Rationale: Representations are statements believed to be true to the best of the applicant's knowledge.
Warranties are absolute guarantees, which are not required in A&H insurance applications.
9. A&H coverage becomes effective when the:
A. First premium has been paid and received in the insurance company's home office
B. First premium has been paid and the application has been approved
C. Producer delivers the policy to the insured
D. Medical examination has been completed and the premium paid
Correct Answer: B. First premium has been paid and the application has been approved
Rationale: Coverage begins once the insurer has approved the application and the initial premium has
been paid, meeting the conditions of a conditional receipt.
2025 NV HEALTH UPDATED EXAM WITH MOST TESTED
QUESTIONS AND ANSWERS | GRADED A+ | ASSURED
SUCCESS WITH DETAILED RATIONALES
1. Which law requires the applicant to be notified before a consumer report is ordered?
A. Fair Labor Standards Act
B. Privacy Protection Act
C. Fair Credit Reporting Act
D. Equal Credit Opportunity Act
Correct Answer: C. Fair Credit Reporting Act
Rationale: The Fair Credit Reporting Act ensures that individuals are notified before a consumer report
is obtained, providing them with the opportunity to dispute any inaccuracies.
2. The Insuring Clause of an A&H policy usually states all of the following EXCEPT:
A. That insurance against loss is provided
B. That a loss must result directly from stated accidents or sicknesses
C. The method of premium payment
D. The identities of the insurance company and the insured
Correct Answer: C. The method of premium payment
Rationale: The Insuring Clause outlines the insurer's promise to pay benefits under certain conditions
but does not specify how premiums are paid.
3. Which of the following statements about Medicare is/are true?
I. Payments are made directly to the hospital providing services rather than to the insured
II. Benefits can continue beyond the hospitalization period
A. I only
B. II only
C. Both I and II
D. Neither I nor II
Correct Answer: C. Both I and II
Rationale: Medicare payments are made directly to providers, and benefits can extend beyond the
hospitalization period through additional coverage like skilled nursing and home health care.
,ESTUDYR
4. The Misstatement of Age provision gives the insurance company the right to:
A. Bring suit for fraud
B. Cancel the contract
C. Adjust benefits payable
D. Reduce dividends payable
Correct Answer: C. Adjust benefits payable
Rationale: The Misstatement of Age provision adjusts benefits or premiums to align with the insured's
correct age, maintaining actuarial fairness.
5. Which of the following statements about group A&H provisions and practices is/are true?
I. Insurance company practices are generally less liberal under Group policies than under Individual
policies
II. Experience rating is generally utilized under Group policies
A. I only
B. II only
C. Both I and II
D. Neither I nor II
Correct Answer: B. II only
Rationale: Group policies often use experience rating to determine premiums based on the claims
history of the group, whereas individual policies focus on the specific applicant's health.
6. A&H insurance provides coverage for sickness and injury that includes which of the following
benefits?
I. Income benefits due to loss of time from work
II. Benefit payments for hospital care
A. I only
B. II only
C. Both I and II
D. Neither I nor II
Correct Answer: C. Both I and II
Rationale: A&H insurance covers both disability income (loss of work) and medical expenses like
hospital care.
, ESTUDYR
7. The part of an HMO policy, which provides for the claim to be shared between the insurer and the
insured, is known as:
A. Deductible
B. Out-of-pocket maximum
C. Co-pay
D. Usual, Customary, and Reasonable
Correct Answer: C. Co-pay
Rationale: A co-pay is a fixed amount paid by the insured for specific services, with the insurer covering
the remaining cost.
8. Answers given by applicants to questions on applications for A&H insurance are considered which
of the following?
I. Representations
II. Warranties
A. I only
B. II only
C. Both I and II
D. Neither I nor II
Correct Answer: A. I only
Rationale: Representations are statements believed to be true to the best of the applicant's knowledge.
Warranties are absolute guarantees, which are not required in A&H insurance applications.
9. A&H coverage becomes effective when the:
A. First premium has been paid and received in the insurance company's home office
B. First premium has been paid and the application has been approved
C. Producer delivers the policy to the insured
D. Medical examination has been completed and the premium paid
Correct Answer: B. First premium has been paid and the application has been approved
Rationale: Coverage begins once the insurer has approved the application and the initial premium has
been paid, meeting the conditions of a conditional receipt.
