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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: Types of Health Insurance Policies20-25%- Individual health insurance
- Group health insurance
- Disability income insurance
- Long-term care insurance
- Medicare and Medicaid
- Dental and vision insurance
Topic 2: Policy Provisions and Clauses18-22%- Benefit periods
- Exclusions and limitations
- Waiting periods
- Coverage terms and conditions
- Preexisting condition clauses
- Deductibles and copayments
Topic 3: Social Insurance Programs8-12%- Medicaid programs
- Medicare Part A, B, C, D
- Social Security disability benefits
- CHIP (Children's Health Insurance Program)
Topic 4: Maryland Insurance Laws and Regulations20-25%- Maryland Insurance Code
- Unfair claim settlement practices
- Producer licensing requirements
- Consumer protection regulations
- Violations and penalty provisions
- Privacy and confidentiality requirements
Topic 5: Field Underwriting and Application Process8-12%- Application procedures
- Medical underwriting
- Risk classification
- Agent responsibilities in enrollment
Topic 6: Marketing Practices8-12%- Producer responsibilities
- Prohibited practices
- Marketing regulations
- Advertising guidelines

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

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

  • A. The chance of loss must be calculable.
  • B. There must be a large number of different loss exposures.
  • C. The loss must be catastrophic.
  • D. The loss must be intentional.
Reveal Solution  Discussion  0

Correct Answer: A  🗳️

Explanation: Only visible for Pass4Leader members. You can sign-up / login (it's free).

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  🗳️

Explanation: Only visible for Pass4Leader members. You can sign-up / login (it's free).

When an accident and health insurer requires a covered individual to undergo a physical examination, who pays the cost of the examination?

  • A. The patient or parent of the patient
  • B. The premium payor
  • C. The insurer
  • D. The principal insured individual
Reveal Solution  Discussion  0

Correct Answer: C  🗳️

Explanation: Only visible for Pass4Leader members. You can sign-up / login (it's free).

Pre-existing conditions include conditions of health that:

  • A. Must exist before an applicant can be accepted by an insurer
  • B. Develop after the effective date of the policy but before the expiration of the time limit on certain defenses
  • C. Have been medically treated or diagnosed prior to the effective date of coverage
  • D. Are never insurable under any circumstances or degree of severity
Reveal Solution  Discussion  0

Correct Answer: C  🗳️

Explanation: Only visible for Pass4Leader members. You can sign-up / login (it's free).

All of the following are characteristics of a preferred risk applicant for disability income insurance EXCEPT:

  • A. High income
  • B. Non-smoker
  • C. Physically active
  • D. Non-hazardous occupation
Reveal Solution  Discussion  0

Correct Answer: A  🗳️

Explanation: Only visible for Pass4Leader members. You can sign-up / login (it's free).

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