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Maryland Insurance Administration Accident-and-Health-or-Sickness-Producer Exam Syllabus Topics:
| Section | Weight | Objectives |
|---|---|---|
| Types of Health Insurance Policies | 20-25% | - Group health insurance - Individual health insurance - Dental and vision insurance - Medicare and Medicaid - Long-term care insurance - Disability income insurance |
| Policy Provisions and Clauses | 18-22% | - Exclusions and limitations - Benefit periods - Coverage terms and conditions - Deductibles and copayments - Waiting periods - Preexisting condition clauses |
| Maryland Insurance Laws and Regulations | 20-25% | - Privacy and confidentiality requirements - Violations and penalty provisions - Maryland Insurance Code - Consumer protection regulations - Unfair claim settlement practices - Producer licensing requirements |
| Marketing Practices | 8-12% | - Prohibited practices - Marketing regulations - Advertising guidelines - Producer responsibilities |
| Social Insurance Programs | 8-12% | - CHIP (Children's Health Insurance Program) - Medicare Part A, B, C, D - Social Security disability benefits - Medicaid programs |
| Field Underwriting and Application Process | 8-12% | - Medical underwriting - Agent responsibilities in enrollment - Application procedures - Risk classification |
Maryland Insurance Administration MarylandAccident and Health or Sickness Producer Series 20-24 Sample Questions:
1. To be deemed a "qualified employer" under the Maryland Health Benefit Exchange Act, anemployer MUST:
A) Have at least 50% of its employees work in the state of Maryland
B) Contribute to employee premiums
C) Have its principal place of business in the state of Maryland
D) Have at least 50% of its employees reside in the state of Maryland
2. When a producer engages in unfair practices, all of the following are true EXCEPT:
A) The Maryland Insurance Administration can suspend the producer's license
B) The Maryland Insurance Administration can investigate the problem and hold a hearing
C) The Maryland Insurance Administration can issue a cease and desist order
D) The Maryland Insurance Administration's decision is final
3. Misrepresenting pertinent policy provisions relating to coverages after a loss is:
A) A concealment in insurance applications
B) An unfair discrimination between individuals
C) An unfair claim settlement practice
D) A violation of the principle of adhesion
4. An insurance producer's license may be suspended or revoked by:
A) The Attorney General
B) The continuing education course provider
C) The appointing insurer
D) The Maryland Insurance Administration
5. Pre-existing conditions include conditions of health that:
A) Have been medically treated or diagnosed prior to the effective date of coverage
B) Are never insurable under any circumstances or degree of severity
C) Must exist before an applicant can be accepted by an insurer
D) Develop after the effective date of the policy but before the expiration of the time limit on certain defenses
Solutions:
| Question # 1 Answer: C | Question # 2 Answer: D | Question # 3 Answer: C | Question # 4 Answer: D | Question # 5 Answer: A |


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