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Maryland Insurance Administration Accident-and-Health-or-Sickness-Producer Exam Syllabus Topics:
| Section | Weight | Objectives |
|---|---|---|
| Social Insurance Programs | 8-12% | - Medicaid programs - Medicare Part A, B, C, D - CHIP (Children's Health Insurance Program) - Social Security disability benefits |
| Types of Health Insurance Policies | 20-25% | - Individual health insurance - Long-term care insurance - Disability income insurance - Dental and vision insurance - Group health insurance - Medicare and Medicaid |
| Marketing Practices | 8-12% | - Advertising guidelines - Marketing regulations - Prohibited practices - Producer responsibilities |
| Maryland Insurance Laws and Regulations | 20-25% | - Unfair claim settlement practices - Violations and penalty provisions - Consumer protection regulations - Producer licensing requirements - Privacy and confidentiality requirements - Maryland Insurance Code |
| Field Underwriting and Application Process | 8-12% | - Medical underwriting - Risk classification - Agent responsibilities in enrollment - Application procedures |
| Policy Provisions and Clauses | 18-22% | - Deductibles and copayments - Exclusions and limitations - Preexisting condition clauses - Coverage terms and conditions - Benefit periods - Waiting periods |
Maryland Insurance Administration MarylandAccident and Health or Sickness Producer Series 20-24 Sample Questions:
Question 1
The Maryland Insurance Administration is an agency of the:
A. National Association of Insurance Commissioners
B. Maryland General Assembly
C. Federal government
D. State government
Question 2
Coverage for the first three pints of blood for Medicare enrollees is:
A. A Medicare Part A benefit
B. A Medicare Supplement core benefit
C. A Medicare Part B benefit
D. A Medicare Supplement additional benefit
Question 3
The entire contract provision in an individual accident and health insurance policy states that the producer:
A. May waive only certain contract provisions
B. Has company authority to waive any contract provisions
C. Has company authority to change the policy
D. Has no authority to change the policy or waive any of its provisions
Question 4
Medical expense insurance typically EXCLUDES coverage for treatment of:
A. Intentionally self-inflicted injuries
B. Undiagnosed diseases
C. Eating disorders
D. Chronic back pain
Question 5
Medical charges that fall within the range of fees normally charged for a given procedure in a certain geographical area are called:
A. Utilization charges
B. Scheduled charges
C. Preapproved charges
D. Reasonable and customary charges
Solutions:
| Question 1 Answer: D | Question 2 Answer: B | Question 3 Answer: D | Question 4 Answer: A | Question 5 Answer: D |
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