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  • Exam Code: Accident-and-Health-or-Sickness-Producer
  • Exam Name: MarylandAccident and Health or Sickness Producer Series 20-24 Exam
  • Q & A: 92 Questions and Answers
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  • Exam Code: Accident-and-Health-or-Sickness-Producer
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  • Q & A: 92 Questions and Answers
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  • Exam Code: Accident-and-Health-or-Sickness-Producer
  • Exam Name: MarylandAccident and Health or Sickness Producer Series 20-24 Exam
  • Q & A: 92 Questions and Answers
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Maryland Insurance Administration Accident-and-Health-or-Sickness-Producer Exam Syllabus Topics:

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

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

                                                    Question #1

                                                    The Maryland Health Insurance Plan is designed to provide comprehensive health benefits for:

                                                    • A. Children of low-income Maryland residents
                                                    • B. Low-income residents of Maryland
                                                    • C. Senior citizens residing in Maryland
                                                    • D. Medically uninsurable Maryland residents
                                                    Reveal Solution  Discussion  0

                                                    Correct Answer: D  🗳️

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                                                    Question #2

                                                    All of the following are typical health maintenance organization (HMO) preventive care services provided by a primary care physician EXCEPT:

                                                    • A. Experimental surgery
                                                    • B. Immunizations for children
                                                    • C. Physical examinations
                                                    • D. Well-baby checkups
                                                    Reveal Solution  Discussion  0

                                                    Correct Answer: A  🗳️

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                                                    Question #3

                                                    Reasonable and customary charges for health care are based primarily on:

                                                    • A. Actuarial tables
                                                    • B. Insurance industry studies
                                                    • C. Average charges within a geographic area
                                                    • D. National physician surveys
                                                    Reveal Solution  Discussion  0

                                                    Correct Answer: C  🗳️

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                                                    Question #4

                                                    When the insured's willful failure to disclose a material fact at the time of application is discovered by the insurer shortly after the policy is issued:

                                                    • A. The insurer must continue the insurance policy in full force
                                                    • B. The insurer may cancel the policy only at the expiration or renewal date
                                                    • C. The policy is voidable at the insurer's option
                                                    • D. The policy is automatically void
                                                    Reveal Solution  Discussion  0

                                                    Correct Answer: C  🗳️

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

                                                    Question #5

                                                    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 insurer
                                                    • C. The principal insured individual
                                                    • D. The premium payor
                                                    Reveal Solution  Discussion  0

                                                    Correct Answer: B  🗳️

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