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

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

                                                    Maryland Insurance Administration MarylandAccident and Health or Sickness Producer Series 20-24 Sample Questions:

                                                    1. Accident and health policies must cover physically or mentally handicapped dependent children:

                                                    A) To age 19
                                                    B) Until they become self-sustaining
                                                    C) To age 25
                                                    D) For life


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

                                                    A) Major medical
                                                    B) Dental
                                                    C) Health maintenance organization
                                                    D) Disability income


                                                    3. An insurer may pay a commission directly or indirectly to:

                                                    A) An unlicensed employee of the insurer
                                                    B) A producer whose license is terminated after earning the commission
                                                    C) Anyone soliciting business for the insurer
                                                    D) A surplus lines broker operating without a license for less than one year


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

                                                    A) Military service
                                                    B) Commercial airline crashes
                                                    C) Injuries occurring in the home
                                                    D) Automobile accidents


                                                    5. 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:

                                                    A) The insurer may cancel the policy only at the expiration or renewal date
                                                    B) The policy is voidable at the insurer's option
                                                    C) The insurer must continue the insurance policy in full force
                                                    D) The policy is automatically void


                                                    Solutions:

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

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