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Maryland Insurance Administration Accident-and-Health-or-Sickness-Producer Exam Syllabus Topics:
| Section | Weight | Objectives |
|---|
| Maryland State-Specific Regulations | 20% | - Compliance and Enforcement
- 1. Penalties and violations
- 2. Reporting and recordkeeping
- Statutory Requirements
- 1. Disclosure and marketing requirements
- 2. Mandatory benefits and coverage mandates
- 3. Claims handling and settlement rules
|
| Insurance Regulation | 30% | - Regulation of Producers
- 1. Compensation and commissions
- 2. Unfair trade practices
- 3. Privacy and confidentiality rules
- Providers and Markets
- 1. Insurers and health service organizations
- 2. HMOs and managed care arrangements
- Licensing
- 1. License issuance, renewal, and termination
- 2. General provisions and definitions
- 3. Initial qualifications and examination
|
| General Insurance Concepts | 15% | - Policy Provisions
- 1. Mandatory and optional clauses
- 2. Exclusions and limitations
- Fundamental Principles
- 1. Insurable interest and indemnity
- 2. Contract law and policy structure
- 3. Risk and risk management
|
| Accident and Health Insurance Policies | 35% | - Types of Coverage
- 1. Accident-only coverage
- 2. Disability income insurance
- 3. Medical expense insurance
- 4. Long-term care insurance
- Policy Features
- 1. Benefit structures and limits
- 2. Pre-existing conditions and exclusions
- 3. Waiting periods and elimination periods
|
Maryland Insurance Administration MarylandAccident and Health or Sickness Producer Series 20-24 Sample Questions:
Pat owns a small business and is interested in enrolling her son in the Maryland Children's Health Insurance Program. Which of the following is the MOST appropriate person for Pat to contact for enrollment?
- A. An Insurance Producer authorized to work in the SHOP Exchange
- B. The Maryland Insurance Commissioner
- C. A SHOP Exchange Navigator
- D. A certified Navigator or authorized Producer for the Individual Exchange
Reveal Solution
Discussion
Correct Answer: D 🗳️
Explanation: Only visible for TestPDF members. You can sign-up / login (it's free).
Which statement describes the most likely federal income tax treatment of death benefits paid to the family of an insured under an accident and health insurance policy?
- A. Taxation depends on the beneficiary's tax bracket
- B. Benefits will not be taxable
- C. All benefits will be taxable
- D. Some benefits will usually be taxable
Reveal Solution
Discussion
Correct Answer: B 🗳️
Explanation: Only visible for TestPDF members. You can sign-up / login (it's free).
In Maryland, continuation of medical plan coverage for a handicapped child beyond the age limit stated in the policy may require proof of the child's:
- A. Incapacity only
- B. Incapacity and dependency upon reaching the age limit
- C. Continued insurability
- D. Dependency for the first two years of continued coverage only
Reveal Solution
Discussion
Correct Answer: B 🗳️
Explanation: Only visible for TestPDF members. You can sign-up / login (it's free).
When a single major medical contract covers all medical expenses, the plan is considered to be:
- A. First-dollar
- B. Limited
- C. Comprehensive
- D. Supplemental
Reveal Solution
Discussion
Correct Answer: C 🗳️
Explanation: Only visible for TestPDF members. You can sign-up / login (it's free).
An insured's statements on an accident and health insurance application are deemed to be:
- A. Warranties
- B. General provisions
- C. Representations
- D. Categorical
Reveal Solution
Discussion
Correct Answer: C 🗳️
Explanation: Only visible for TestPDF members. You can sign-up / login (it's free).
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