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Maryland Insurance Administration Accident-and-Health-or-Sickness-Producer Exam Syllabus Topics:
| Section | Weight | Objectives |
| Maryland State-Specific Regulations | 20% | - Compliance and Enforcement
- 1. Reporting and recordkeeping
- 2. Penalties and violations
- Statutory Requirements
- 1. Disclosure and marketing requirements
- 2. Mandatory benefits and coverage mandates
- 3. Claims handling and settlement rules
|
| Insurance Regulation | 30% | - Regulation of Producers
- 1. Unfair trade practices
- 2. Privacy and confidentiality rules
- 3. Compensation and commissions
- Providers and Markets
- 1. Insurers and health service organizations
- 2. HMOs and managed care arrangements
- Licensing
- 1. General provisions and definitions
- 2. License issuance, renewal, and termination
- 3. Initial qualifications and examination
|
| Accident and Health Insurance Policies | 35% | - Types of Coverage
- 1. Accident-only coverage
- 2. Disability income insurance
- 3. Long-term care insurance
- 4. Medical expense insurance
- Policy Features
- 1. Waiting periods and elimination periods
- 2. Pre-existing conditions and exclusions
- 3. Benefit structures and limits
|
| General Insurance Concepts | 15% | - Policy Provisions
- 1. Mandatory and optional clauses
- 2. Exclusions and limitations
- Fundamental Principles
- 1. Insurable interest and indemnity
- 2. Contract law and policy structure
- 3. Risk and risk management
|
Maryland Insurance Administration MarylandAccident and Health or Sickness Producer Series 20-24 Sample Questions:
1. All of the following are examples of unfair claims settlement practices EXCEPT:
A) Denying unsubstantiated claims on a timely basis
B) Refusing arbitrarily and unreasonably to pay claims
C) Failing to promptly provide a reason for a claim denial
D) Misrepresenting pertinent facts of coverage
2. Which one of the following causes of death typically would be included under an accidental death rider attached to a life insurance policy?
A) Intentionally self-inflicted injuries
B) Illness or disease
C) War or acts of war
D) Automobile accidents resulting from the insured's negligence
3. An accident and health insurance producer is most likely to become liable for professional errors and omissions as the result of:
A) Incorrect filing of federal income taxes
B) Misleading a prospective insured in replacing accident and health insurance
C) Submitting a premium payment to an insurer in excess of the required amount
D) An accounting error discovered by the producer's accountant
4. Which benefit is usually excluded from major medical expense plan coverage?
A) Physical therapy
B) Routine dental care
C) Prescription drugs
D) Hospice care
5. The Maryland Insurance Administration is an agency of the:
A) State government
B) Federal government
C) Maryland General Assembly
D) National Association of Insurance Commissioners
Solutions:
Question # 1 Answer: A | Question # 2 Answer: D | Question # 3 Answer: B | Question # 4 Answer: B | Question # 5 Answer: A |