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Maryland Insurance Administration Accident-and-Health-or-Sickness-Producer Exam Syllabus Topics:
| Section | Weight | Objectives |
|---|---|---|
| Policy Provisions and Clauses | 18-22% | - Benefit periods - Waiting periods - Deductibles and copayments - Preexisting condition clauses - Coverage terms and conditions - Exclusions and limitations |
| Field Underwriting and Application Process | 8-12% | - Risk classification - Application procedures - Medical underwriting - Agent responsibilities in enrollment |
| Marketing Practices | 8-12% | - Marketing regulations - Advertising guidelines - Producer responsibilities - Prohibited practices |
| Types of Health Insurance Policies | 20-25% | - Disability income insurance - Group health insurance - Dental and vision insurance - Medicare and Medicaid - Individual health insurance - Long-term care insurance |
| Social Insurance Programs | 8-12% | - Medicaid programs - Medicare Part A, B, C, D - CHIP (Children's Health Insurance Program) - Social Security disability benefits |
| Maryland Insurance Laws and Regulations | 20-25% | - Privacy and confidentiality requirements - Producer licensing requirements - Unfair claim settlement practices - Violations and penalty provisions - Maryland Insurance Code - Consumer protection regulations |
Maryland Insurance Administration MarylandAccident and Health or Sickness Producer Series 20-24 Sample Questions:
1. The Maryland State Benchmark Plan applies to which of the following?
A) Medicaid plans sold through the Exchange
B) Medicare supplement plans sold outside the Exchange prior to January 1, 2014
C) Individual Health Benefit Plans sold through the Exchange
D) Individual Health Benefit Plans sold outside the Exchange prior to January 1, 2014
2. In general practice, can the Maryland Insurance Administration inspect the business records of an insurance company or agency?
A) No, because of privacy considerations
B) No, because only an officer of the court can inspect these records
C) Yes, because all company and agency records are public domain
D) Yes, because of the powers defined by state laws
3. If an insurer pays an individual accident and health insurance claim during a policy's grace period:
A) The amount of unpaid premium may be subtracted from the reimbursement
B) A 10% service fee is charged
C) The deductible is waived
D) The policy is canceled automatically at the end of the grace period
4. An insurance adviser's written contract with the client must include all of the following EXCEPT:
A) Disclosure as to whether commissions may be received
B) Duration of the contract
C) Expiration date of the consultant's license
D) Amount of the fee
5. A nonprofit health service plan may NOT issue a contract that covers which of the following types of benefits?
A) Dental benefits
B) Medical expense benefits
C) Vision benefits
D) Disability income benefits
Solutions:
| Question # 1 Answer: C | Question # 2 Answer: D | Question # 3 Answer: A | Question # 4 Answer: C | Question # 5 Answer: D |


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