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Maryland Insurance Administration Accident-and-Health-or-Sickness-Producer Exam Syllabus Topics:
| Section | Weight | Objectives |
|---|---|---|
| Maryland Insurance Laws and Regulations | 20-25% | - Consumer protection regulations - Unfair claim settlement practices - Maryland Insurance Code - Producer licensing requirements - Violations and penalty provisions - Privacy and confidentiality requirements |
| Policy Provisions and Clauses | 18-22% | - Deductibles and copayments - Exclusions and limitations - Preexisting condition clauses - Coverage terms and conditions - Waiting periods - Benefit periods |
| Social Insurance Programs | 8-12% | - CHIP (Children's Health Insurance Program) - Medicare Part A, B, C, D - Social Security disability benefits - Medicaid programs |
| Types of Health Insurance Policies | 20-25% | - Medicare and Medicaid - Disability income insurance - Group health insurance - Dental and vision insurance - Individual health insurance - Long-term care insurance |
| Marketing Practices | 8-12% | - Prohibited practices - Advertising guidelines - Marketing regulations - Producer responsibilities |
| Field Underwriting and Application Process | 8-12% | - Application procedures - Medical underwriting - Agent responsibilities in enrollment - Risk classification |
Maryland Insurance Administration MarylandAccident and Health or Sickness Producer Series 20-24 Sample Questions:
1. Which of the following is NOT a mandated benefit in Maryland?
A) Treatment of mental illness
B) Weight reduction programs
C) Treatment of substance abuse
D) Hearing aids for children
2. If an employer with 200 employees wants to offer health insurance and calls a SHOP Exchange Navigator, what should the navigator do?
A) Refer the employer to a licensed insurance producer
B) Refer the employer to the carrier where a friend works
C) Help the employer sign-up through the SHOP Exchange
D) Refer the employer to the Maryland Insurance Administration
3. Which statement is true of trade association groups eligible for group medical benefits?
A) Employer contributions are usually waived
B) Such associations are formed for the purpose of purchasing insurance
C) Members of the association are usually in the same industry
D) The association membership primarily consists of large employers
4. If an insurer pays an individual accident and health insurance claim during a policy's grace period:
A) The amount of unpaid premium may be subtracted from the reimbursement
B) The deductible is waived
C) The policy is canceled automatically at the end of the grace period
D) A 10% service fee is charged
5. The Maryland State Benchmark Plan applies to which of the following?
A) Individual Health Benefit Plans sold through the Exchange
B) Individual Health Benefit Plans sold outside the Exchange prior to January 1, 2014
C) Medicaid plans sold through the Exchange
D) Medicare supplement plans sold outside the Exchange prior to January 1, 2014
Solutions:
| Question # 1 Answer: B | Question # 2 Answer: A | Question # 3 Answer: C | Question # 4 Answer: A | Question # 5 Answer: A |






