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Accident-and-Health-or-Sickness-Producer MarylandAccident and Health or Sickness Producer Series 20-24 Exam Questions and Answers

Questions 4

Which benefit is usually excluded from major medical expense plan coverage?

Options:

A.

Hospice care

B.

Prescription drugs

C.

Routine dental care

D.

Physical therapy

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Questions 5

All of the following factors may affect premium determination in individual life insurance EXCEPT:

Options:

A.

Age

B.

Health

C.

Occupation

D.

Race

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Questions 6

In Maryland, continuation of medical plan coverage for a handicapped child beyond the age limit stated in the policy may require proof of the child’s:

Options:

A.

Continued insurability

B.

Incapacity only

C.

Incapacity and dependency upon reaching the age limit

D.

Dependency for the first two years of continued coverage only

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Questions 7

Medical charges that fall within the range of fees normally charged for a given procedure in a certain geographical area are called:

Options:

A.

Reasonable and customary charges

B.

Preapproved charges

C.

Utilization charges

D.

Scheduled charges

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Questions 8

Misrepresenting pertinent policy provisions relating to coverages after a loss is:

Options:

A.

A concealment in insurance applications

B.

An unfair claim settlement practice

C.

An unfair discrimination between individuals

D.

A violation of the principle of adhesion

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Questions 9

After completing an application for insurance, the insurance producer collects the premiums but deposits the check in the insurance producer’s checking account. What crime has been committed?

Options:

A.

Twisting

B.

Rebating

C.

Fraud

D.

Replacement

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Questions 10

An accident and health insurance producer is most likely to become liable for professional errors and omissions as the result of:

Options:

A.

An accounting error discovered by the producer’s accountant

B.

Submitting a premium payment to an insurer in excess of the required amount

C.

Incorrect filing of federal income taxes

D.

Misleading a prospective insured in replacing accident and health insurance

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Questions 11

When a single major medical contract covers all medical expenses, the plan is considered to be:

Options:

A.

Comprehensive

B.

Limited

C.

First-dollar

D.

Supplemental

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Questions 12

Which type of Medicare Supplement information can be used without prior state approval?

Options:

A.

Insurance company brochures

B.

Radio announcements approved by the insurer

C.

Television advertisements approved by the insurer

D.

Government publications

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Questions 13

A health maintenance organization (HMO) must provide coverage for all of the following EXCEPT:

Options:

A.

Routine physical examinations

B.

Well-baby or well-child care

C.

Dental and vision care

D.

Emergency services

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Questions 14

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

Options:

A.

The appointing insurer

B.

The continuing education course provider

C.

The Maryland Insurance Administration

D.

The Attorney General

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Questions 15

The phrase, "this policy pays $1,800 for hospital room and board expenses," should include the:

Options:

A.

Maximum daily benefit and the maximum time limit for hospital room and board expenses

B.

Minimum daily benefit and the maximum time limit for hospital room and board expenses

C.

Minimum daily benefit and the minimum time limit for hospital room and board expenses

D.

Maximum daily benefit and the minimum time limit for hospital room and board expenses

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Questions 16

The Maryland Health Insurance Plan is designed to provide comprehensive health benefits for:

Options:

A.

Low-income residents of Maryland

B.

Senior citizens residing in Maryland

C.

Medically uninsurable Maryland residents

D.

Children of low-income Maryland residents

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Questions 17

To be eligible for major medical extended care benefits, a patient must:

Options:

A.

Be terminally ill

B.

Have had surgery

C.

Require physical therapy

D.

Require continuous skilled nursing care

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Questions 18

Which of the following is a requirement of an insurable risk?

Options:

A.

The loss must be intentional.

B.

The loss must be catastrophic.

C.

The chance of loss must be calculable.

D.

There must be a large number of different loss exposures.

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Questions 19

The Maryland State Benchmark Plan applies to which of the following?

Options:

A.

Medicaid plans sold through the Exchange

B.

Individual Health Benefit Plans sold through the Exchange

C.

Medicare supplement plans sold outside the Exchange prior to January 1, 2014

D.

Individual Health Benefit Plans sold outside the Exchange prior to January 1, 2014

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Questions 20

In dental insurance coverage, which one of the following typically is EXCLUDED?

Options:

A.

Treatment started prior to the eligibility date

B.

Preventive care

C.

Dental X-rays

D.

Root canal therapy

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Questions 21

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?

Options:

A.

Fraud

B.

Discrimination

C.

Twisting

D.

Rebating

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Questions 22

In general practice, which one of the following is true of the powers of the Maryland Insurance Administration with respect to access to a producer’s business records?

Options:

A.

Records can only be accessed by an order of a state court

B.

Authorization must come from the National Association of Insurance Commissioners (NAIC)

C.

Records must be produced upon the request of the Maryland Insurance Administration

D.

The Maryland Insurance Administration has no right to access a producer’s business records because of privacy considerations

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Questions 23

An insured incurs a covered accident and health insurance loss on May 30, which is submitted to the insurer on June 8. If the insured terminated coverage on June 1, the insurer:

Options:

A.

Can refuse to pay the claim because coverage has been terminated

B.

Can refuse to pay the claim under the pre-existing conditions exclusion

C.

Must pay the claim upon receipt of the proof of loss

D.

Must pay the claim within one year of termination of coverage

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Questions 24

Short-term group disability income insurance:

Options:

A.

Usually provides benefits expressed as a percentage of the insured’s normal weekly wage, up to a specified weekly maximum

B.

Usually coordinates the amount of benefits paid with disability benefits received under Social Security

C.

Often has a benefit period extending up to a maximum of ten years

D.

Frequently provides coverage through age 65 for insureds who are over 55 when they become disabled

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Questions 25

A disability income insurance policy typically provides coverage for disabilities resulting from:

Options:

A.

Accidents only

B.

Sickness only

C.

Both accidents and sickness

D.

Occupational accidents only

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Questions 26

The entire contract provision in an individual accident and health insurance policy states that the producer:

Options:

A.

Has company authority to change the policy

B.

May waive only certain contract provisions

C.

Has company authority to waive any contract provisions

D.

Has no authority to change the policy or waive any of its provisions

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Questions 27

When the employer pays the premium, covered individuals normally receive tax-free benefits under all of the following group health plans EXCEPT:

Options:

A.

Disability income

B.

Major medical

C.

Dental

D.

Health maintenance organization

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Exam Name: MarylandAccident and Health or Sickness Producer Series 20-24 Exam
Last Update: Mar 14, 2025
Questions: 90
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