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

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

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

                                                    Question #1

                                                    The waiver of premium provision in a disability income policy provides that premiums will be waived during:

                                                    • A. The disability benefit period
                                                    • B. The time limit on certain defenses
                                                    • C. The grace period
                                                    • D. The elimination period
                                                    Reveal Solution  Discussion  0

                                                    Correct Answer: A  🗳️

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                                                    Question #2

                                                    The Maryland Health Insurance Plan is designed to provide comprehensive health benefits for:

                                                    • A. Senior citizens residing in Maryland
                                                    • B. Medically uninsurable Maryland residents
                                                    • C. Children of low-income Maryland residents
                                                    • D. Low-income residents of Maryland
                                                    Reveal Solution  Discussion  0

                                                    Correct Answer: B  🗳️

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                                                    Question #3

                                                    When determining the premiums for large groups, most insurance companies use:

                                                    • A. Occupational rating
                                                    • B. Experience rating
                                                    • C. Area rating
                                                    • D. Pooled rating
                                                    Reveal Solution  Discussion  0

                                                    Correct Answer: B  🗳️

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                                                    Question #4

                                                    An insurance producer or advisor in the State of Maryland can be disciplined by the MarylandInsurance Administration for all of the following EXCEPT:

                                                    • A. Using inappropriate description of a policy to hide the true nature of the policy
                                                    • B. Making false or misleading statements about dividends previously paid on similar policies
                                                    • C. Making a misleading statement about the financial condition of an insurer
                                                    • D. Filing a complaint on behalf of the consumer with the Maryland Insurance Administration
                                                    Reveal Solution  Discussion  0

                                                    Correct Answer: D  🗳️

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                                                    Question #5

                                                    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. Continued insurability
                                                    • B. Incapacity only
                                                    • C. Incapacity and dependency upon reaching the age limit
                                                    • D. Dependency for the first two years of continued coverage only
                                                    Reveal Solution  Discussion  0

                                                    Correct Answer: C  🗳️

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