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Accident-and-Health-or-Sickness-Producer PDF Practice Q&A's

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

SectionWeightObjectives
Topic 1: Maryland State-Specific Regulations20%- Statutory Requirements
  • 1. Claims handling and settlement rules
    • 2. Mandatory benefits and coverage mandates
      • 3. Disclosure and marketing requirements
        - Compliance and Enforcement
        • 1. Penalties and violations
          • 2. Reporting and recordkeeping
            Topic 2: General Insurance Concepts15%- Policy Provisions
            • 1. Mandatory and optional clauses
              • 2. Exclusions and limitations
                - Fundamental Principles
                • 1. Insurable interest and indemnity
                  • 2. Risk and risk management
                    • 3. Contract law and policy structure
                      Topic 3: Accident and Health Insurance Policies35%- Types of Coverage
                      • 1. Disability income insurance
                        • 2. Long-term care insurance
                          • 3. Medical expense insurance
                            • 4. Accident-only coverage
                              - Policy Features
                              • 1. Benefit structures and limits
                                • 2. Pre-existing conditions and exclusions
                                  • 3. Waiting periods and elimination periods
                                    Topic 4: Insurance Regulation30%- Providers and Markets
                                    • 1. HMOs and managed care arrangements
                                      • 2. Insurers and health service organizations
                                        - Regulation of Producers
                                        • 1. Unfair trade practices
                                          • 2. Privacy and confidentiality rules
                                            • 3. Compensation and commissions
                                              - Licensing
                                              • 1. License issuance, renewal, and termination
                                                • 2. Initial qualifications and examination
                                                  • 3. General provisions and definitions

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

                                                    1. When a single major medical contract covers all medical expenses, the plan is considered to be:

                                                    A) First-dollar
                                                    B) Supplemental
                                                    C) Comprehensive
                                                    D) Limited


                                                    2. The entire contract provision in an individual accident and health insurance policy states that the producer:

                                                    A) Has no authority to change the policy or waive any of its provisions
                                                    B) May waive only certain contract provisions
                                                    C) Has company authority to change the policy
                                                    D) Has company authority to waive any contract provisions


                                                    3. Which of the following is a requirement of an insurable risk?

                                                    A) The loss must be catastrophic.
                                                    B) The chance of loss must be calculable.
                                                    C) The loss must be intentional.
                                                    D) There must be a large number of different loss exposures.


                                                    4. An insurance producer's license may be suspended or revoked by:

                                                    A) The appointing insurer
                                                    B) The Maryland Insurance Administration
                                                    C) The Attorney General
                                                    D) The continuing education course provider


                                                    5. The Maryland Insurance Administration is an agency of the:

                                                    A) Maryland General Assembly
                                                    B) Federal government
                                                    C) National Association of Insurance Commissioners
                                                    D) State government


                                                    Solutions:

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

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