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

SectionObjectives
Topic 1: Accident and Health Insurance Basics- Types of coverage
  • 1. Disability income insurance
    • 2. Medical expense insurance
      • 3. Accidental death & dismemberment (AD&D)
        - Policy structure and provisions
        • 1. Definitions and clauses
          • 2. Exclusions and limitations
            Topic 2: Health Insurance Systems- Government health programs
            • 1. Medicaid basics
              • 2. Medicare basics
                - Managed care models
                • 1. HMO, PPO, POS
                  Topic 3: Insurance Law and Regulation (Maryland)- Maryland Insurance Administration rules
                  • 1. Unfair trade practices (rebating, twisting, misrepresentation)
                    • 2. Producer licensing requirements
                      Topic 4: Policy Administration and Ethics- Ethical obligations
                      • 1. Disclosure requirements
                        • 2. Suitability and fiduciary duties
                          Topic 5: General Insurance Principles- Insurance concepts
                          • 1. Principles of indemnity and insurable interest
                            • 2. Risk, peril, hazard

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

                              1. An insurance producer provided several examples to the applicant persuasively demonstrating that the insurance coverage offered under his company's policy was superior to a competitor's product. The insurance producer knew he was misrepresenting or stretching the truth in order to induce the applicant to forfeit her current policy and purchase a similar but inferior insurance policy from him. The insurance producer is involved in which one of the following unfair trade practices?

                              A) Twisting
                              B) Fraud
                              C) Discrimination
                              D) Rebating


                              2. Which of the following is a requirement of an insurable risk?

                              A) The chance of loss must be calculable.
                              B) There must be a large number of different loss exposures.
                              C) The loss must be intentional.
                              D) The loss must be catastrophic.


                              3. All of the following are common features found in health maintenance organizations (HMOs) EXCEPT:

                              A) Wellness programs
                              B) Outpatient medical services
                              C) Twenty-four hour access to emergency care
                              D) Discounts on local health spa memberships


                              4. In Maryland, continuation of medical plan coverage for a handicapped child beyond the age limit stated in the policy may require proof of the child's:

                              A) Incapacity and dependency upon reaching the age limit
                              B) Continued insurability
                              C) Incapacity only
                              D) Dependency for the first two years of continued coverage only


                              5. An elimination period in a disability income insurance policy is the:

                              A) Period between the start of a disability and the beginning of benefits
                              B) Time during which benefits are paid under the policy
                              C) Same as the probationary period
                              D) Time period the policy is in force


                              Solutions:

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

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