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

SectionWeightObjectives
General Insurance Concepts15%- Fundamental Principles
  • 1. Contract law and policy structure
    • 2. Insurable interest and indemnity
      • 3. Risk and risk management
        - Policy Provisions
        • 1. Exclusions and limitations
          • 2. Mandatory and optional clauses
            Maryland State-Specific Regulations20%- Compliance and Enforcement
            • 1. Reporting and recordkeeping
              • 2. Penalties and violations
                - Statutory Requirements
                • 1. Mandatory benefits and coverage mandates
                  • 2. Claims handling and settlement rules
                    • 3. Disclosure and marketing requirements
                      Insurance Regulation30%- Providers and Markets
                      • 1. HMOs and managed care arrangements
                        • 2. Insurers and health service organizations
                          - Regulation of Producers
                          • 1. Unfair trade practices
                            • 2. Privacy and confidentiality rules
                              • 3. Compensation and commissions
                                - Licensing
                                • 1. License issuance, renewal, and termination
                                  • 2. Initial qualifications and examination
                                    • 3. General provisions and definitions
                                      Accident and Health Insurance Policies35%- Policy Features
                                      • 1. Benefit structures and limits
                                        • 2. Waiting periods and elimination periods
                                          • 3. Pre-existing conditions and exclusions
                                            - Types of Coverage
                                            • 1. Accident-only coverage
                                              • 2. Medical expense insurance
                                                • 3. Disability income insurance
                                                  • 4. Long-term care insurance

                                                    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) Fraud
                                                    B) Twisting
                                                    C) Discrimination
                                                    D) Rebating


                                                    2. In Maryland, an insurance producer is a person who solicits, negotiates, or sells insurance plans PRIMARILY in conjunction with:

                                                    A) Acting as a regularly salaried officer
                                                    B) Earning commission
                                                    C) Enrolling individuals in group plans
                                                    D) Performing clerical duties


                                                    3. An insurance producer's license may be suspended or revoked by:

                                                    A) The Maryland Insurance Administration
                                                    B) The Attorney General
                                                    C) The appointing insurer
                                                    D) The continuing education course provider


                                                    4. Which expenses are covered by Medicare Part D?

                                                    A) Medical
                                                    B) Hospital
                                                    C) Prescription drug
                                                    D) Dental


                                                    5. Coverage for the first three pints of blood for Medicare enrollees is:

                                                    A) A Medicare Part B benefit
                                                    B) A Medicare Supplement additional benefit
                                                    C) A Medicare Part A benefit
                                                    D) A Medicare Supplement core benefit


                                                    Solutions:

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

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