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Maryland Insurance Administration Accident-and-Health-or-Sickness-Producer Exam Syllabus Topics:
| Section | Weight | Objectives |
|---|---|---|
| Field Underwriting and Application Process | 8-12% | - Application procedures - Agent responsibilities in enrollment - Medical underwriting - Risk classification |
| Policy Provisions and Clauses | 18-22% | - Deductibles and copayments - Coverage terms and conditions - Exclusions and limitations - Preexisting condition clauses - Waiting periods - Benefit periods |
| Social Insurance Programs | 8-12% | - Medicaid programs - Medicare Part A, B, C, D - CHIP (Children's Health Insurance Program) - Social Security disability benefits |
| Marketing Practices | 8-12% | - Marketing regulations - Prohibited practices - Advertising guidelines - Producer responsibilities |
| Maryland Insurance Laws and Regulations | 20-25% | - Maryland Insurance Code - Violations and penalty provisions - Unfair claim settlement practices - Producer licensing requirements - Consumer protection regulations - Privacy and confidentiality requirements |
| Types of Health Insurance Policies | 20-25% | - Disability income insurance - Medicare and Medicaid - Individual health insurance - Dental and vision insurance - Group health insurance - Long-term care insurance |
Maryland Insurance Administration MarylandAccident and Health or Sickness Producer Series 20-24 Sample Questions:
1. A health maintenance organization may issue a contract that provides benefits for the following:
A) Health care services provided to members of the HMO
B) The accidental death of an HMO member
C) The dismemberment of an HMO member
D) Replacement of income lost by a member due to the member's disability
2. Which expenses are covered by Medicare Part D?
A) Dental
B) Hospital
C) Medical
D) Prescription drug
3. Under Maryland law, the agreement between an insurance producer and insurer under which the insurance producer, for compensation, may sell, solicit, or negotiate policies issued by the insurer is defined as:
A) An appointment
B) A certificate of authority
C) A license
D) A binding agreement
4. In HMO coverage, all of the following services must be available 24 hours per day, 7 days per week EXCEPT:
A) Dental care
B) In-patient hospital services
C) Emergency medical care
D) Primary care
5. A health maintenance organization (HMO) must provide coverage for all of the following EXCEPT:
A) Emergency services
B) Routine physical examinations
C) Well-baby or well-child care
D) Dental and vision care
Solutions:
| Question # 1 Answer: A | Question # 2 Answer: D | Question # 3 Answer: A | Question # 4 Answer: A | Question # 5 Answer: D |
