Nevada Health Insurance Practice Exam Free - 2026

• A. 10 days
• B. 15 days
• C. 20 days after the occurrence or commencement of the loss, or as soon thereafter as reasonably possible
• D. 90 days

Correct answer: C. 20 days after the occurrence or commencement of the loss, or as soon thereafter as reasonably possible

Explanation: NRS 689A.090 requires every individual health policy to provide that written notice of claim must be given within 20 days after the occurrence or commencement of any loss covered by the policy, or as soon thereafter as is reasonably possible. Fifteen days is the period in which the insurer must furnish claim forms, 90 days is the proof-of-loss period, and 10 days is not a notice period. See NRS 689A.090.

• A. Within 90 days after the date of the loss
• B. Within 20 days after the date of the loss
• C. Within 60 days after the date of the loss
• D. Within 6 months after the date of the loss

Correct answer: A. Within 90 days after the date of the loss

Explanation: NRS 689A.110 requires a provision that written proof of loss be furnished within 90 days after the date of the loss (or within 90 days after the end of the period for which the insurer is liable, for periodic-payment claims), with late proof accepted if it was not reasonably possible to comply, but no later than 1 year absent legal incapacity. Twenty days is the notice-of-claim period, 60 days is the waiting period before a legal action may be filed, and 6 months has no basis. See NRS 689A.110.

• A. The claim is automatically paid
• B. The insured must wait until the forms arrive before submitting proof
• C. The claim is denied for failure to use the insurer's forms
• D. After 15 days the claimant is deemed to have complied with the proof-of-loss requirement by submitting written proof of the occurrence, character and extent of the loss

Correct answer: D. After 15 days the claimant is deemed to have complied with the proof-of-loss requirement by submitting written proof of the occurrence, character and extent of the loss

Explanation: NRS 689A.100 requires a provision that the insurer will furnish claim forms upon receipt of notice of claim, and if the forms are not furnished within 15 days the claimant is deemed to have complied with the proof-of-loss requirements by submitting, within the time fixed for proofs, written proof covering the occurrence, character and extent of the loss. The claim is not automatically paid or denied, and the claimant need not wait for the forms. See NRS 689A.100.

• A. Immediately, and within 1 year after proof was required
• B. Not before 60 days after written proof of loss was furnished, and not after 3 years after the time proof of loss is required to be furnished
• C. Not before 30 days after proof, and not after 2 years
• D. Not before 90 days after proof, and not after 5 years

Correct answer: B. Not before 60 days after written proof of loss was furnished, and not after 3 years after the time proof of loss is required to be furnished

Explanation: NRS 689A.150 requires a provision that no action at law or in equity may be brought to recover on the policy before the expiration of 60 days after written proof of loss has been furnished, and no action may be brought after 3 years after the time written proof of loss is required to be furnished. The other combinations of waiting periods and limitation periods are not Nevada's. See NRS 689A.150.

• A. State programs providing health insurance to individuals unable to obtain coverage elsewhere
• B. Federal programs providing health insurance to low-income families with dependent children
• C. Insurer-funded pools that pay the claims of a member company that becomes insolvent
• D. Reinsurance arrangements spreading an insurer's largest health claims among other carriers

Correct answer: A. State programs providing health insurance to individuals unable to obtain coverage elsewhere

Explanation: High-risk pools are state-sponsored health insurance programs designed to cover individuals who cannot obtain coverage in the private market due to pre-existing conditions. The ACA reduced their need.

• A. Catastrophic Hospital Indemnity Plan paying a fixed daily benefit for inpatient stays
• B. Children's Health Insurance Program providing coverage for uninsured children
• C. A federal program providing prescription drug coverage to children enrolled in Medicare
• D. A federal-state program providing health coverage to disabled adults with low incomes

Correct answer: B. Children's Health Insurance Program providing coverage for uninsured children

Explanation: CHIP (Children's Health Insurance Program) is a federal-state program providing health coverage to uninsured children in families with incomes too high for Medicaid but too low for private insurance.

• A. The tendency for insured individuals to use more care because they do not bear its full cost
• B. The practice of insurers declining applicants whose risk exceeds underwriting limits
• C. The tendency for higher-risk individuals to seek more insurance coverage
• D. The tendency for lower-risk individuals to purchase more coverage than they need

Correct answer: C. The tendency for higher-risk individuals to seek more insurance coverage

Explanation: Adverse selection occurs when individuals with higher health risks are more likely to purchase insurance, while healthier people may decline coverage, leading to a disproportionate number of claims.

• A. The tendency for people in poor health to buy more coverage than healthy people
• B. A physical condition of the insured that increases the chance of loss
• C. The insurer's practice of denying claims it believes were not medically necessary
• D. The tendency to use more services because insurance covers them

Correct answer: D. The tendency to use more services because insurance covers them

Explanation: Moral hazard in health insurance is the tendency for insured individuals to use more medical services or take less care of their health because they don't bear the full cost of their decisions.

• A. A Medical Information Bureau (MIB) report
• B. An inspection report
• C. An attending physician statement (APS)
• D. An agent's certification

Correct answer: C. An attending physician statement (APS)

Explanation: An attending physician statement is a report the underwriter requests, with the applicant's written authorization, from a physician who has treated the applicant. It provides detail the application and MIB codes cannot - diagnoses, treatment dates, and prognosis. The MIB, by contrast, is an industry database of brief coded underwriting information shared among member insurers.

• A. The policy was issued on a rated (substandard) basis
• B. The applicant was declined
• C. The policy includes an impairment exclusion rider
• D. The applicant received a preferred classification

Correct answer: A. The policy was issued on a rated (substandard) basis

Explanation: When health history raises the expected risk but the applicant is still insurable, the insurer can issue a rated - also called substandard - policy at a higher premium. That differs from an exclusion rider, which carves a named condition out of coverage, and from declination. Disability insurers may also shorten the benefit period or lengthen the elimination period for substandard risks.

• A. The quality of the doctors in the plan's network
• B. The average share of covered medical costs the plan pays
• C. How large the insurance company is
• D. How quickly the plan processes claims

Correct answer: B. The average share of covered medical costs the plan pays

Explanation: Metal levels reflect actuarial value - the average percentage of covered costs a plan pays across a standard population: roughly 60% for Bronze, 70% for Silver, 80% for Gold, and 90% for Platinum. Higher metal levels mean higher premiums but lower out-of-pocket costs. The levels say nothing about provider quality or claims service.

• A. The insurer must renew coverage and may not raise the premium at renewal
• B. The insurer must accept any new applicant regardless of health status
• C. The insurer may decline renewal if the insured's health has declined
• D. The insurer must renew coverage as long as premiums are paid

Correct answer: D. The insurer must renew coverage as long as premiums are paid

Explanation: Guaranteed renewability means the insurer cannot refuse to renew coverage as long as premiums are paid. The insurer can increase premiums for the entire class but cannot single out individuals.