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Maryland Insurance Administration Accident-and-Health-or-Sickness-Producer Exam Syllabus Topics:
| Section | Weight | Objectives |
|---|---|---|
| Marketing Practices | 8-12% | - Prohibited practices - Marketing regulations - Producer responsibilities - Advertising guidelines |
| Policy Provisions and Clauses | 18-22% | - Preexisting condition clauses - Benefit periods - Waiting periods - Deductibles and copayments - Coverage terms and conditions - Exclusions and limitations |
| Social Insurance Programs | 8-12% | - Social Security disability benefits - CHIP (Children's Health Insurance Program) - Medicare Part A, B, C, D - Medicaid programs |
| Types of Health Insurance Policies | 20-25% | - Long-term care insurance - Group health insurance - Individual health insurance - Medicare and Medicaid - Dental and vision insurance - Disability income insurance |
| Maryland Insurance Laws and Regulations | 20-25% | - Privacy and confidentiality requirements - Unfair claim settlement practices - Consumer protection regulations - Violations and penalty provisions - Maryland Insurance Code - Producer licensing requirements |
| Field Underwriting and Application Process | 8-12% | - Agent responsibilities in enrollment - Medical underwriting - 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) Contribute to employee premiums
B) Have at least 50% of its employees reside in the state of Maryland
C) Have its principal place of business in the state of Maryland
D) Have at least 50% of its employees work in the state of Maryland
2. Which benefit is usually excluded from major medical expense plan coverage?
A) Prescription drugs
B) Routine dental care
C) Physical therapy
D) Hospice care
3. After completing an application for insurance, the insurance producer collects the premiums but deposits the check in the insurance producer's checking account. What crime has been committed?
A) Fraud
B) Replacement
C) Rebating
D) Twisting
4. An insured incurs a covered accident and health insurance loss on May 30, which is submitted to the insurer on June 8. If the insured terminated coverage on June 1, the insurer:
A) Must pay the claim upon receipt of the proof of loss
B) Can refuse to pay the claim under the pre-existing conditions exclusion
C) Must pay the claim within one year of termination of coverage
D) Can refuse to pay the claim because coverage has been terminated
5. In Maryland, an insurance producer is a person who solicits, negotiates, or sells insurance plans PRIMARILY in conjunction with:
A) Earning commission
B) Performing clerical duties
C) Enrolling individuals in group plans
D) Acting as a regularly salaried officer
Solutions:
| Question # 1 Answer: C | Question # 2 Answer: B | Question # 3 Answer: A | Question # 4 Answer: A | Question # 5 Answer: A |







