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Maryland Insurance Administration Accident-and-Health-or-Sickness-Producer Exam Syllabus Topics:

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

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

                                                    Question #1

                                                    Short-term group disability income insurance:

                                                    • A. Usually coordinates the amount of benefits paid with disability benefits received under Social Security
                                                    • B. Frequently provides coverage through age 65 for insureds who are over 55 when they become disabled
                                                    • C. Usually provides benefits expressed as a percentage of the insured's normal weekly wage, up to a specified weekly maximum
                                                    • D. Often has a benefit period extending up to a maximum of ten years
                                                    Reveal Solution  Discussion  0

                                                    Correct Answer: C  🗳️

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

                                                    Question #2

                                                    Which feature in a long-term care insurance policy is designed specifically to provide benefits at times when family members need a break from caring for the insured?

                                                    • A. Respite care
                                                    • B. Custodial facility care
                                                    • C. Home health care
                                                    • D. Skilled nursing facility care
                                                    Reveal Solution  Discussion  0

                                                    Correct Answer: A  🗳️

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

                                                    Question #3

                                                    To be eligible for major medical extended care benefits, a patient must:

                                                    • A. Be terminally ill
                                                    • B. Require continuous skilled nursing care
                                                    • C. Require physical therapy
                                                    • D. Have had surgery
                                                    Reveal Solution  Discussion  0

                                                    Correct Answer: B  🗳️

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

                                                    Question #4

                                                    The primary purpose of disability income insurance is to:

                                                    • A. Provide benefit payments for a period of time when the insured is unable to work
                                                    • B. Pay necessary hospital expenses when the insured is unable to work
                                                    • C. Pay any physicians' fees resulting from a disabling injury
                                                    • D. Provide indemnity for loss of life
                                                    Reveal Solution  Discussion  0

                                                    Correct Answer: A  🗳️

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

                                                    Question #5

                                                    If an employer with 200 employees wants to offer health insurance and calls a SHOP Exchange Navigator, what should the navigator do?

                                                    • A. Help the employer sign-up through the SHOP Exchange
                                                    • B. Refer the employer to the Maryland Insurance Administration
                                                    • C. Refer the employer to the carrier where a friend works
                                                    • D. Refer the employer to a licensed insurance producer
                                                    Reveal Solution  Discussion  0

                                                    Correct Answer: D  🗳️

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

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