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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: Accident and Health Insurance Policies35%- Types of Coverage
  • 1. Medical expense insurance
    • 2. Long-term care insurance
      • 3. Disability income insurance
        • 4. Accident-only coverage
          - Policy Features
          • 1. Waiting periods and elimination periods
            • 2. Pre-existing conditions and exclusions
              • 3. Benefit structures and limits
                Topic 2: Maryland State-Specific Regulations20%- Compliance and Enforcement
                • 1. Reporting and recordkeeping
                  • 2. Penalties and violations
                    - Statutory Requirements
                    • 1. Mandatory benefits and coverage mandates
                      • 2. Disclosure and marketing requirements
                        • 3. Claims handling and settlement rules
                          Topic 3: Insurance Regulation30%- Providers and Markets
                          • 1. HMOs and managed care arrangements
                            • 2. Insurers and health service organizations
                              - Regulation of Producers
                              • 1. Privacy and confidentiality rules
                                • 2. Unfair trade practices
                                  • 3. Compensation and commissions
                                    - Licensing
                                    • 1. Initial qualifications and examination
                                      • 2. General provisions and definitions
                                        • 3. License issuance, renewal, and termination
                                          Topic 4: General Insurance Concepts15%- Fundamental Principles
                                          • 1. Risk and risk management
                                            • 2. Contract law and policy structure
                                              • 3. Insurable interest and indemnity
                                                - Policy Provisions
                                                • 1. Exclusions and limitations
                                                  • 2. Mandatory and optional clauses

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

                                                    All of the following services are covered under the Medicare Supplement preventive care benefit EXCEPT:

                                                    • A. Immunizations
                                                    • B. Outpatient prescription vitamins
                                                    • C. Routine physical examinations
                                                    • D. Hearing tests
                                                    Answer: B

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

                                                    The primary purpose of disability income insurance is to:

                                                    • A. Pay any physicians' fees resulting from a disabling injury
                                                    • B. Provide benefit payments for a period of time when the insured is unable to work
                                                    • C. Provide indemnity for loss of life
                                                    • D. Pay necessary hospital expenses when the insured is unable to work
                                                    Answer: B

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

                                                    A nonprofit health service plan may NOT issue a contract that covers which of the following types of benefits?

                                                    • A. Medical expense benefits
                                                    • B. Dental benefits
                                                    • C. Disability income benefits
                                                    • D. Vision benefits
                                                    Answer: C

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

                                                    Which benefit is usually excluded from accident and health plan coverage?

                                                    • A. Physicians' visits
                                                    • B. Surgical expense
                                                    • C. Custodial care
                                                    • D. Hospital expense
                                                    Answer: C

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

                                                    Which of the following is NOT a mandated benefit in Maryland?

                                                    • A. Treatment of mental illness
                                                    • B. Hearing aids for children
                                                    • C. Treatment of substance abuse
                                                    • D. Weight reduction programs
                                                    Answer: D

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

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