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Maryland Insurance Administration Accident-and-Health-or-Sickness-Producer Exam Syllabus Topics:
| Section | Weight | Objectives |
|---|---|---|
| Topic 1: Maryland Insurance Laws and Regulations | 20-25% | - Unfair claim settlement practices - Violations and penalty provisions - Maryland Insurance Code - Producer licensing requirements - Consumer protection regulations - Privacy and confidentiality requirements |
| Topic 2: Field Underwriting and Application Process | 8-12% | - Application procedures - Agent responsibilities in enrollment - Risk classification - Medical underwriting |
| Topic 3: Social Insurance Programs | 8-12% | - Medicaid programs - Medicare Part A, B, C, D - Social Security disability benefits - CHIP (Children's Health Insurance Program) |
| Topic 4: Policy Provisions and Clauses | 18-22% | - Exclusions and limitations - Deductibles and copayments - Waiting periods - Benefit periods - Preexisting condition clauses - Coverage terms and conditions |
| Topic 5: Types of Health Insurance Policies | 20-25% | - Disability income insurance - Individual health insurance - Group health insurance - Long-term care insurance - Dental and vision insurance - Medicare and Medicaid |
| Topic 6: Marketing Practices | 8-12% | - Prohibited practices - Marketing regulations - Advertising guidelines - Producer responsibilities |
Maryland Insurance Administration MarylandAccident and Health or Sickness Producer Series 20-24 Sample Questions:
Question 1
If an individual's occupation is considered to be illegal:
A. It may result in a denial of a disability income claim
B. It results in a substandard rating on an accident and health insurance policy
C. It may require a waiver on a disability income insurance policy
D. It must be stated as such on an accident and health insurance application
Question 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 the carrier where a friend works
B. Refer the employer to the Maryland Insurance Administration
C. Help the employer sign-up through the SHOP Exchange
D. Refer the employer to a licensed insurance producer
Question 3
Giving policyholders some part of the agent's commission as an inducement to purchase insurance is an unfair trade practice known as:
A. Rebating
B. Retention
C. Twisting
D. Replacement
Question 4
Reasonable and customary charges for health care are based primarily on:
A. Actuarial tables
B. Average charges within a geographic area
C. National physician surveys
D. Insurance industry studies
Question 5
All of the following are characteristics of a preferred risk applicant for disability income insurance EXCEPT:
A. Non-hazardous occupation
B. High income
C. Non-smoker
D. Physically active
Solutions:
| Question 1 Answer: A | Question 2 Answer: D | Question 3 Answer: A | Question 4 Answer: B | Question 5 Answer: B |








