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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:
| Section | Weight | Objectives |
|---|---|---|
| Topic 1: Types of Health Insurance Policies | 20-25% | - 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 Clauses | 18-22% | - Benefit periods - Exclusions and limitations - Waiting periods - Coverage terms and conditions - Preexisting condition clauses - Deductibles and copayments |
| Topic 3: Social Insurance Programs | 8-12% | - Medicaid programs - Medicare Part A, B, C, D - Social Security disability benefits - CHIP (Children's Health Insurance Program) |
| Topic 4: Maryland Insurance Laws and Regulations | 20-25% | - 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 Process | 8-12% | - Application procedures - Medical underwriting - Risk classification - Agent responsibilities in enrollment |
| Topic 6: Marketing Practices | 8-12% | - 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.
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
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
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
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
Correct Answer: A 🗳️
Explanation: Only visible for Pass4Leader members. You can sign-up / login (it's free).
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