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Maryland Insurance Administration Accident-and-Health-or-Sickness-Producer Exam Syllabus Topics:
| Section | Weight | Objectives |
|---|---|---|
| Policy Provisions and Clauses | 18-22% | - Preexisting condition clauses - Coverage terms and conditions - Waiting periods - Deductibles and copayments - Benefit periods - Exclusions and limitations |
| Types of Health Insurance Policies | 20-25% | - Dental and vision insurance - Medicare and Medicaid - Disability income insurance - Long-term care insurance - Group health insurance - Individual health insurance |
| Field Underwriting and Application Process | 8-12% | - Application procedures - Risk classification - Medical underwriting - Agent responsibilities in enrollment |
| Maryland Insurance Laws and Regulations | 20-25% | - Privacy and confidentiality requirements - Producer licensing requirements - Maryland Insurance Code - Violations and penalty provisions - Unfair claim settlement practices - Consumer protection regulations |
| Marketing Practices | 8-12% | - Prohibited practices - Producer responsibilities - Advertising guidelines - Marketing regulations |
| Social Insurance Programs | 8-12% | - Medicaid programs - Medicare Part A, B, C, D - Social Security disability benefits - CHIP (Children's Health Insurance Program) |
Maryland Insurance Administration MarylandAccident and Health or Sickness Producer Series 20-24 Sample Questions:
1. Medicare Supplement insurance is specifically designed for individuals who:
A) Have low incomes and limited assets
B) Have enrolled in Medicare
C) Cannot obtain commercial coverage due to health problems
D) Are ineligible for coverage under an employer group accident and health plan
2. In dental insurance coverage, which one of the following typically is EXCLUDED?
A) Root canal therapy
B) Preventive care
C) Treatment started prior to the eligibility date
D) Dental X-rays
3. Pat owns a small business and is interested in enrolling her son in the Maryland Children's Health Insurance Program. Which of the following is the MOST appropriate person for Pat to contact for enrollment?
A) An Insurance Producer authorized to work in the SHOP Exchange
B) A certified Navigator or authorized Producer for the Individual Exchange
C) The Maryland Insurance Commissioner
D) A SHOP Exchange Navigator
4. Coverage for the first three pints of blood for Medicare enrollees is:
A) A Medicare Supplement core benefit
B) A Medicare Part B benefit
C) A Medicare Part A benefit
D) A Medicare Supplement additional benefit
5. An insurance producer or advisor in the State of Maryland can be disciplined by the MarylandInsurance Administration for all of the following EXCEPT:
A) Making a misleading statement about the financial condition of an insurer
B) Making false or misleading statements about dividends previously paid on similar policies
C) Using inappropriate description of a policy to hide the true nature of the policy
D) Filing a complaint on behalf of the consumer with the Maryland Insurance Administration
Solutions:
| Question # 1 Answer: B | Question # 2 Answer: C | Question # 3 Answer: B | Question # 4 Answer: A | Question # 5 Answer: D |






