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Maryland Insurance Administration MarylandAccident and Health or Sickness Producer Series 20-24 Exam Sample Questions (Q75-Q80):
NEW QUESTION # 75
To be deemed a "qualified employer" under the Maryland Health Benefit Exchange Act, anemployer MUST:
Answer: A
Explanation:
The Maryland Health Benefit Exchange Act (Insurance Article, § 31-101) defines a qualified employer as one with its principal place of business in Maryland for SHOP Exchange eligibility. Premium contributions are optional, and employee work or residency percentages aren't required.
References:Maryland Insurance Article, § 31-101; MIA SHOP Exchange rules.
NEW QUESTION # 76
A health maintenance organization may issue a contract that provides benefits for the following:
Answer: A
Explanation:
HMOs (Health-General Article, § 19-701) provide health care services to members, not income replacement (disability insurance), accidental death, or dismemberment benefits (life/accident insurance).
References:Maryland Health-General Article, § 19-701; MIA HMO guidelines.
NEW QUESTION # 77
In accident and health insurance, a waiting period for pre-existing conditions means that:
Answer: D
Explanation:
A waiting period (Insurance Article, § 15-109) delays coverage for pre-existing conditions (e.g., 6-12 months), not permanently excluding them, starting at inception, or holding payments in escrow.
References:Maryland Insurance Article, § 15-109; MIA pre-existing condition rules.
NEW QUESTION # 78
Medical expense insurance typically EXCLUDES coverage for:
Answer: B
Explanation:
Medical expense insurance covers necessary treatments like hospital stays, maternity care, and diagnostic tests, but excludes elective procedures such as primarily cosmetic surgery unless medically necessary (e.g., reconstructive surgery post-injury). Maryland law (Insurance Article, § 15-103) allows exclusions for non- essential services, aligning with standard practice where aesthetic surgeries like facelifts are not covered.
References:Maryland Insurance Article, § 15-103; MIA guidelines.
NEW QUESTION # 79
In general practice, which one of the following is true of the powers of the Maryland Insurance Administration with respect to access to a producer's business records?
Answer: A
Explanation:
The MIA (Insurance Article, § 2-207) can request and access producer records for audits or investigations, overriding privacy for regulatory purposes. Court orders or NAIC approval aren't required, and access is a standard power.
References:Maryland Insurance Article, § 2-207; MIA regulatory authority.
NEW QUESTION # 80
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