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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. Benefit structures and limits
    • 2. Pre-existing conditions and exclusions
      • 3. Waiting periods and elimination periods
        - Types of Coverage
        • 1. Disability income insurance
          • 2. Medical expense insurance
            • 3. Long-term care insurance
              • 4. Accident-only coverage
                Insurance Regulation30%- Providers and Markets
                • 1. Insurers and health service organizations
                  • 2. HMOs and managed care arrangements
                    - Licensing
                    • 1. Initial qualifications and examination
                      • 2. License issuance, renewal, and termination
                        • 3. General provisions and definitions
                          - Regulation of Producers
                          • 1. Compensation and commissions
                            • 2. Privacy and confidentiality rules
                              • 3. Unfair trade practices
                                General Insurance Concepts15%- Policy Provisions
                                • 1. Exclusions and limitations
                                  • 2. Mandatory and optional clauses
                                    - Fundamental Principles
                                    • 1. Contract law and policy structure
                                      • 2. Risk and risk management
                                        • 3. Insurable interest and indemnity
                                          Maryland State-Specific Regulations20%- Statutory Requirements
                                          • 1. Claims handling and settlement rules
                                            • 2. Mandatory benefits and coverage mandates
                                              • 3. Disclosure and marketing requirements
                                                - 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. Which type of Medicare Supplement information can be used without prior state approval?

                                                    A) Television advertisements approved by the insurer
                                                    B) Radio announcements approved by the insurer
                                                    C) Government publications
                                                    D) Insurance company brochures


                                                    2. Which statement describes the most likely federal income tax treatment of death benefits paid to the family of an insured under an accident and health insurance policy?

                                                    A) All benefits will be taxable
                                                    B) Some benefits will usually be taxable
                                                    C) Taxation depends on the beneficiary's tax bracket
                                                    D) Benefits will not be taxable


                                                    3. Under which marketing system do insurers solicit customers by mass media advertising and mail without the services of a producer?

                                                    A) Captive agent
                                                    B) Direct response
                                                    C) Branch office
                                                    D) Contingent


                                                    4. Which one of the following causes of death typically would be included under an accidental death rider attached to a life insurance policy?

                                                    A) Illness or disease
                                                    B) Intentionally self-inflicted injuries
                                                    C) War or acts of war
                                                    D) Automobile accidents resulting from the insured's negligence


                                                    5. All advertisements for health insurance shall make clear the identity of the:

                                                    A) Insurer
                                                    B) Insured
                                                    C) Beneficiary
                                                    D) Insurance Commissioner


                                                    Solutions:

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

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