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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

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

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Questions 5

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 6

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 7

The waiver of premium provision in a disability income policy provides that premiums will be waived during:

Options:

A.

The disability benefit period

B.

The elimination period

C.

The grace period

D.

The time limit on certain defenses

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Questions 8

All of the following are considered to be fraud EXCEPT:

Options:

A.

Willfully collecting a premium that exceeds the amount of the premium

B.

Collecting a charge for insurance that is less than the charge applicable to that insurance

C.

Collecting a premium for insurance that is not provided

D.

Collecting a proper premium for insurance that is provided

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Questions 9

In general practice, can the Maryland Insurance Administration inspect the business records of an insurance company or agency?

Options:

A.

No, because of privacy considerations

B.

Yes, because of the powers defined by state laws

C.

No, because only an officer of the court can inspect these records

D.

Yes, because all company and agency records are public domain

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Questions 10

In HMO coverage, all of the following services must be available 24 hours per day, 7 days per week EXCEPT:

Options:

A.

In-patient hospital services

B.

Emergency medical care

C.

Primary care

D.

Dental care

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Questions 11

An insurance policy could be issued to cover losses resulting from any of the following EXCEPT:

Options:

A.

A drug smuggling operation

B.

A skydiving exhibition

C.

A state-sponsored centennial celebration

D.

A nuclear power plant

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Questions 12

In Maryland, an insurance producer is a person who solicits, negotiates, or sells insurance plans PRIMARILY in conjunction with:

Options:

A.

Earning commission

B.

Performing clerical duties

C.

Enrolling individuals in group plans

D.

Acting as a regularly salaried officer

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Questions 13

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

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Questions 14

Which statement is true of trade association groups eligible for group medical benefits?

Options:

A.

Members of the association are usually in the same industry

B.

Such associations are formed for the purpose of purchasing insurance

C.

The association membership primarily consists of large employers

D.

Employer contributions are usually waived

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Questions 15

An insurance adviser’s written contract with the client must include all of the following EXCEPT:

Options:

A.

Expiration date of the consultant’s license

B.

Amount of the fee

C.

Duration of the contract

D.

Disclosure as to whether commissions may be received

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Questions 16

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 17

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

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Questions 18

When a producer sells an individual accident and health insurance policy, how is the initial premium usually paid?

Options:

A.

The applicant sends it directly to the insurer with the application

B.

The producer collects and forwards it to the insurer

C.

The insurer bills the applicant when the application is approved

D.

The insurer utilizes the applicant’s automatic bank draft authorization

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Questions 19

In accident and health insurance, a waiting period for pre-existing conditions means that:

Options:

A.

Coverage for pre-existing conditions is permanently excluded by a new insurer

B.

Coverage for pre-existing conditions starts at the inception of the new policy

C.

Payment for expenses resulting from pre-existing conditions is held in escrow

D.

A period of time must elapse before pre-existing conditions are covered

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Questions 20

All of the following services are covered under the Medicare Supplement preventive care benefit EXCEPT:

Options:

A.

Immunizations

B.

Hearing tests

C.

Outpatient prescription vitamins

D.

Routine physical examinations

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Questions 21

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 22

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 23

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

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Questions 24

Reasonable and customary charges for health care are based primarily on:

Options:

A.

Actuarial tables

B.

Insurance industry studies

C.

Average charges within a geographic area

D.

National physician surveys

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Questions 25

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

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Questions 26

Medical expense insurance typically EXCLUDES coverage for treatment of:

Options:

A.

Chronic back pain

B.

Eating disorders

C.

Intentionally self-inflicted injuries

D.

Undiagnosed diseases

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Questions 27

The free-look period provided in a life insurance policy is usually:

Options:

A.

10 days

B.

31 days

C.

45 days

D.

60 days

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Exam Name: MarylandAccident and Health or Sickness Producer Series 20-24 Exam
Last Update: Apr 2, 2025
Questions: 90

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