Special Summer Sale Limited Time Flat 70% Discount offer - Ends in 0d 00h 00m 00s - Coupon code: 70spcl

Maryland Insurance Administration Accident-and-Health-or-Sickness-Producer MarylandAccident and Health or Sickness Producer Series 20-24 Exam Exam Practice Test

Page: 1 / 9
Total 90 questions

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

Question 1

In accident and health insurance underwriting, when the risk imposed by an applicant is similar to the risks imposed by most other applicants, the applicant is:

Options:

A.

Declined coverage

B.

Charged the standard premium rate

C.

Required to pay the first year’s premium in a lump sum

D.

Charged an additional premium for the first three years

Question 2

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

Question 3

A certificate of insurance in a group accident and health plan is:

Options:

A.

A binding contract between the employee and the insurer

B.

A binding contract between the employer and the insurer

C.

Evidence of the employee’s insurance coverage

D.

Issued to the employer for each insured location

Question 4

All of the following are basic underwriting actions in accident and health insurance EXCEPT:

Options:

A.

Rejecting applicants

B.

Deleting uniform policy provisions

C.

Issuing standard policies as applied for

D.

Issuing policies with exclusion riders

Question 5

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:

Options:

A.

An appointment

B.

A binding agreement

C.

A certificate of authority

D.

A license

Question 6

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

Options:

A.

A Medicare Supplement additional benefit

B.

A Medicare Supplement core benefit

C.

A Medicare Part A benefit

D.

A Medicare Part B benefit

Question 7

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

Question 8

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

Question 9

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

Question 10

When an accident and health insurer requires a covered individual to undergo a physical examination, who pays the cost of the examination?

Options:

A.

The premium payor

B.

The principal insured individual

C.

The patient or parent of the patient

D.

The insurer

Question 11

If an insurer pays an individual accident and health insurance claim during a policy’s grace period:

Options:

A.

The deductible is waived

B.

A 10% service fee is charged

C.

The policy is canceled automatically at the end of the grace period

D.

The amount of unpaid premium may be subtracted from the reimbursement

Question 12

Medical expense insurance typically EXCLUDES coverage for:

Options:

A.

Hospital care extending past 30 days

B.

Expenses incurred for primarily cosmetic surgery

C.

Maternity care benefits

D.

Hospital laboratory tests

Question 13

When the insured’s willful failure to disclose a material fact at the time of application is discovered by the insurer shortly after the policy is issued:

Options:

A.

The insurer must continue the insurance policy in full force

B.

The insurer may cancel the policy only at the expiration or renewal date

C.

The policy is automatically void

D.

The policy is voidable at the insurer’s option

Question 14

Who has the right to change the beneficiary of an accident and health policy with a revocable beneficiary designation?

Options:

A.

The policyowner

B.

The beneficiary

C.

The insurer

D.

The producer

Question 15

Pre-existing conditions include conditions of health that:

Options:

A.

Are never insurable under any circumstances or degree of severity

B.

Must exist before an applicant can be accepted by an insurer

C.

Have been medically treated or diagnosed prior to the effective date of coverage

D.

Develop after the effective date of the policy but before the expiration of the time limit on certain defenses

Question 16

All of the following are typical health maintenance organization (HMO) preventive care services provided by a primary care physician EXCEPT:

Options:

A.

Well-baby checkups

B.

Immunizations for children

C.

Experimental surgery

D.

Physical examinations

Question 17

A nonprofit health service plan may NOT issue a contract that covers which of the following types of benefits?

Options:

A.

Vision benefits

B.

Disability income benefits

C.

Medical expense benefits

D.

Dental benefits

Question 18

When determining the premiums for large groups, most insurance companies use:

Options:

A.

Occupational rating

B.

Area rating

C.

Pooled rating

D.

Experience rating

Question 19

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

Question 20

Which benefit is usually excluded from accident and health plan coverage?

Options:

A.

Hospital expense

B.

Custodial care

C.

Physicians’ visits

D.

Surgical expense

Question 21

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

Question 22

If an employer with 200 employees wants to offer health insurance and calls a SHOP Exchange Navigator, what should the navigator do?

Options:

A.

Refer the employer to a licensed insurance producer

B.

Help the employer sign-up through the SHOP Exchange

C.

Refer the employer to the carrier where a friend works

D.

Refer the employer to the Maryland Insurance Administration

Question 23

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

Question 24

An insurer may pay a commission directly or indirectly to:

Options:

A.

Anyone soliciting business for the insurer

B.

An unlicensed employee of the insurer

C.

A producer whose license is terminated after earning the commission

D.

A surplus lines broker operating without a license for less than one year

Question 25

An insurance producer or advisor in the State of Maryland can be disciplined by the MarylandInsurance Administration for all of the following EXCEPT:

Options:

A.

Making a misleading statement about the financial condition of an insurer

B.

Using inappropriate description of a policy to hide the true nature of the policy

C.

Making false or misleading statements about dividends previously paid on similar policies

D.

Filing a complaint on behalf of the consumer with the Maryland Insurance Administration

Question 26

The primary purpose of disability income insurance is to:

Options:

A.

Provide indemnity for loss of life

B.

Pay necessary hospital expenses when the insured is unable to work

C.

Provide benefit payments for a period of time when the insured is unable to work

D.

Pay any physicians’ fees resulting from a disabling injury

Question 27

The typical group disability income insurance policy EXCLUDES coverage for disability resulting from:

Options:

A.

Commercial airline crashes

B.

Injuries occurring in the home

C.

Automobile accidents

D.

Military service

Page: 1 / 9
Total 90 questions