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

SectionWeightObjectives
Policy Provisions and Clauses18-22%- Preexisting condition clauses
- Coverage terms and conditions
- Benefit periods
- Waiting periods
- Exclusions and limitations
- Deductibles and copayments
Field Underwriting and Application Process8-12%- Medical underwriting
- Agent responsibilities in enrollment
- Risk classification
- Application procedures
Maryland Insurance Laws and Regulations20-25%- Consumer protection regulations
- Producer licensing requirements
- Violations and penalty provisions
- Privacy and confidentiality requirements
- Unfair claim settlement practices
- Maryland Insurance Code
Types of Health Insurance Policies20-25%- Long-term care insurance
- Dental and vision insurance
- Individual health insurance
- Group health insurance
- Medicare and Medicaid
- Disability income insurance
Social Insurance Programs8-12%- Medicare Part A, B, C, D
- Social Security disability benefits
- CHIP (Children's Health Insurance Program)
- Medicaid programs
Marketing Practices8-12%- Advertising guidelines
- Marketing regulations
- Prohibited practices
- Producer responsibilities

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

1. Misrepresenting pertinent policy provisions relating to coverages after a loss is:

A) An unfair claim settlement practice
B) A violation of the principle of adhesion
C) An unfair discrimination between individuals
D) A concealment in insurance applications


2. All of the following are true of insurance EXCEPT:

A) It protects against uncertainty
B) It is a means of sharing losses
C) It transfers risk
D) It eliminates risk


3. In HMO coverage, all of the following services must be available 24 hours per day, 7 days per week EXCEPT:

A) Dental care
B) Primary care
C) Emergency medical care
D) In-patient hospital services


4. Which expenses are covered by Medicare Part D?

A) Dental
B) Medical
C) Hospital
D) Prescription drug


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

A) Vision benefits
B) Disability income benefits
C) Medical expense benefits
D) Dental benefits


Solutions:

Question # 1
Answer: A
Question # 2
Answer: D
Question # 3
Answer: A
Question # 4
Answer: D
Question # 5
Answer: B

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