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Maryland Insurance Administration Accident-and-Health-or-Sickness-Producer Exam Syllabus Topics:

SectionWeightObjectives
Types of Health Insurance Policies20-25%- Dental and vision insurance
- Group health insurance
- Medicare and Medicaid
- Disability income insurance
- Long-term care insurance
- Individual health insurance
Policy Provisions and Clauses18-22%- Benefit periods
- Preexisting condition clauses
- Coverage terms and conditions
- Exclusions and limitations
- Waiting periods
- Deductibles and copayments
Marketing Practices8-12%- Advertising guidelines
- Marketing regulations
- Producer responsibilities
- Prohibited practices
Social Insurance Programs8-12%- Medicare Part A, B, C, D
- CHIP (Children's Health Insurance Program)
- Medicaid programs
- Social Security disability benefits
Field Underwriting and Application Process8-12%- Agent responsibilities in enrollment
- Medical underwriting
- Application procedures
- Risk classification
Maryland Insurance Laws and Regulations20-25%- Producer licensing requirements
- Maryland Insurance Code
- Privacy and confidentiality requirements
- Violations and penalty provisions
- Consumer protection regulations
- Unfair claim settlement practices

Maryland Insurance Administration MarylandAccident and Health or Sickness Producer Series 20-24 Sample Questions:

1. An insurer may pay a commission directly or indirectly to:

A) A producer whose license is terminated after earning the commission
B) Anyone soliciting business for the insurer
C) A surplus lines broker operating without a license for less than one year
D) An unlicensed employee of the insurer


2. If an insurer pays an individual accident and health insurance claim during a policy's grace period:

A) The policy is canceled automatically at the end of the grace period
B) The deductible is waived
C) The amount of unpaid premium may be subtracted from the reimbursement
D) A 10% service fee is charged


3. Which statement is true of trade association groups eligible for group medical benefits?

A) Employer contributions are usually waived
B) Members of the association are usually in the same industry
C) Such associations are formed for the purpose of purchasing insurance
D) The association membership primarily consists of large employers


4. Medical expense insurance typically EXCLUDES coverage for treatment of:

A) Eating disorders
B) Chronic back pain
C) Intentionally self-inflicted injuries
D) Undiagnosed diseases


5. All advertisements for health insurance shall make clear the identity of the:

A) Beneficiary
B) Insured
C) Insurer
D) Insurance Commissioner


Solutions:

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

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