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Maryland Insurance Administration Accident-and-Health-or-Sickness-Producer Exam Syllabus Topics:
| Section | Weight | Objectives |
|---|---|---|
| Topic 1: Policy Provisions and Clauses | 18-22% | - Deductibles and copayments - Waiting periods - Coverage terms and conditions - Preexisting condition clauses - Exclusions and limitations - Benefit periods |
| Topic 2: Maryland Insurance Laws and Regulations | 20-25% | - Producer licensing requirements - Violations and penalty provisions - Consumer protection regulations - Maryland Insurance Code - Privacy and confidentiality requirements - Unfair claim settlement practices |
| Topic 3: Social Insurance Programs | 8-12% | - Medicaid programs - Social Security disability benefits - CHIP (Children's Health Insurance Program) - Medicare Part A, B, C, D |
| Topic 4: Types of Health Insurance Policies | 20-25% | - Medicare and Medicaid - Long-term care insurance - Individual health insurance - Group health insurance - Dental and vision insurance - Disability income insurance |
| Topic 5: Marketing Practices | 8-12% | - Marketing regulations - Producer responsibilities - Prohibited practices - Advertising guidelines |
| Topic 6: Field Underwriting and Application Process | 8-12% | - Agent responsibilities in enrollment - Medical underwriting - Risk classification - Application procedures |
Maryland Insurance Administration MarylandAccident and Health or Sickness Producer Series 20-24 Sample Questions:
1. Which one of the following causes of loss typically is EXCLUDED under a disability income insurance policy?
A) Tropical disease
B) Auto accidents
C) Intentionally self-inflicted injuries
D) Cancer
2. When an accident and health insurer requires a covered individual to undergo a physical examination, who pays the cost of the examination?
A) The insurer
B) The patient or parent of the patient
C) The principal insured individual
D) The premium payor
3. Before issuing a policy of long-term care insurance to an applicant who is at least 80 years old, unless the policy is guaranteed issue, the carrier shall obtain a:
A) Applicant's family's consent
B) Power of attorney
C) Copy of the person's living will
D) Report of a physical examination
4. Coverage for the first three pints of blood for Medicare enrollees is:
A) A Medicare Part A benefit
B) A Medicare Part B benefit
C) A Medicare Supplement core benefit
D) A Medicare Supplement additional benefit
5. When the employer pays the premium, covered individuals normally receive tax-free benefits under all of the following group health plans EXCEPT:
A) Dental
B) Disability income
C) Health maintenance organization
D) Major medical
Solutions:
| Question # 1 Answer: C | Question # 2 Answer: A | Question # 3 Answer: D | Question # 4 Answer: C | Question # 5 Answer: B |
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