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

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

Question 1

Which of the following is NOT a mandated benefit in Maryland?

Options:

A.

Treatment of mental illness

B.

Treatment of substance abuse

C.

Weight reduction programs

D.

Hearing aids for children

Question 2

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 3

An insured’s statements on an accident and health insurance application are deemed to be:

Options:

A.

Representations

B.

Warranties

C.

Categorical

D.

General provisions

Question 4

Medicare Supplement insurance is specifically designed for individuals who:

Options:

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

Question 5

When a single major medical contract covers all medical expenses, the plan is considered to be:

Options:

A.

Comprehensive

B.

Limited

C.

First-dollar

D.

Supplemental

Question 6

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 7

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

Question 8

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

Options:

A.

Insurance Commissioner

B.

Beneficiary

C.

Insurer

D.

Insured

Question 9

Disability income insurance premiums are a deductible expense when the premiums are paid by:

Options:

A.

A partnership for group disability income coverage for the partners

B.

A corporation for group disability income coverage for the employees

C.

An insured for individual disability income coverage

D.

An employee for group disability income coverage

Question 10

A disability income insurance policy typically provides coverage for disabilities resulting from:

Options:

A.

Accidents only

B.

Sickness only

C.

Both accidents and sickness

D.

Occupational accidents only

Question 11

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 12

All of the following are characteristics of a preferred risk applicant for disability income insurance EXCEPT:

Options:

A.

Non-smoker

B.

Non-hazardous occupation

C.

High income

D.

Physically active

Question 13

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 14

A health maintenance organization may issue a contract that provides benefits for the following:

Options:

A.

Replacement of income lost by a member due to the member’s disability

B.

Health care services provided to members of the HMO

C.

The accidental death of an HMO member

D.

The dismemberment of an HMO member

Question 15

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

Question 16

A health maintenance organization (HMO) must provide coverage for all of the following EXCEPT:

Options:

A.

Routine physical examinations

B.

Well-baby or well-child care

C.

Dental and vision care

D.

Emergency services

Question 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

Question 18

All of the following are true of insurance EXCEPT:

Options:

A.

It transfers risk

B.

It is a means of sharing losses

C.

It eliminates risk

D.

It protects against uncertainty

Question 19

Which of the following is a requirement of an insurable risk?

Options:

A.

The loss must be intentional.

B.

The loss must be catastrophic.

C.

The chance of loss must be calculable.

D.

There must be a large number of different loss exposures.

Question 20

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 21

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

Question 22

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 23

Giving policyholders some part of the agent’s commission as an inducement to purchase insurance is an unfair trade practice known as:

Options:

A.

Twisting

B.

Rebating

C.

Replacement

D.

Retention

Question 24

An accident and health insurance producer is most likely to become liable for professional errors and omissions as the result of:

Options:

A.

An accounting error discovered by the producer’s accountant

B.

Submitting a premium payment to an insurer in excess of the required amount

C.

Incorrect filing of federal income taxes

D.

Misleading a prospective insured in replacing accident and health insurance

Question 25

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 26

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?

Options:

A.

A SHOP Exchange Navigator

B.

The Maryland Insurance Commissioner

C.

An Insurance Producer authorized to work in the SHOP Exchange

D.

A certified Navigator or authorized Producer for the Individual Exchange

Question 27

An insured incurs a covered accident and health insurance loss on May 30, which is submitted to the insurer on June 8. If the insured terminated coverage on June 1, the insurer:

Options:

A.

Can refuse to pay the claim because coverage has been terminated

B.

Can refuse to pay the claim under the pre-existing conditions exclusion

C.

Must pay the claim upon receipt of the proof of loss

D.

Must pay the claim within one year of termination of coverage