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Maryland Insurance Administration MarylandAccident and Health or Sickness Producer Series 20-24 Exam Sample Questions (Q13-Q18):
NEW QUESTION # 13
When a single major medical contract covers all medical expenses, the plan is considered to be:
- A. Supplemental
- B. Comprehensive
- C. Limited
- D. First-dollar
Answer: B
Explanation:
A single policy covering all medical expenses (Insurance Article, § 15-201) is comprehensive, unlike limited (specific), first-dollar (no deductible), or supplemental (add-on) plans.
References:Maryland Insurance Article, § 15-201; MIA major medical standards.
NEW QUESTION # 14
All advertisements for health insurance shall make clear the identity of the:
- A. Insured
- B. Beneficiary
- C. Insurance Commissioner
- D. Insurer
Answer: D
Explanation:
Advertisements must identify the insurer (Insurance Article, § 27-503) to ensure transparency and avoid confusion. The Commissioner, beneficiary, and insured aren't required in ads, as they don't issue the policy.
References:Maryland Insurance Article, § 27-503; MIA advertising guidelines.
NEW QUESTION # 15
Reasonable and customary charges for health care are based primarily on:
- A. Actuarial tables
- B. Average charges within a geographic area
- C. Insurance industry studies
- D. National physician surveys
Answer: B
Explanation:
Reasonable and customary charges (Insurance Article, § 15-1005) reflect average fees for procedures in a specific geographic area (e.g., 80th percentile), ensuring fair reimbursement. Actuarial tables, studies, and national surveys aren't the primary basis.
References:Maryland Insurance Article, § 15-1005; MIA health insurance guidelines.
NEW QUESTION # 16
An insurance adviser's written contract with the client must include all of the following EXCEPT:
- A. Duration of the contract
- B. Expiration date of the consultant's license
- C. Amount of the fee
- D. Disclosure as to whether commissions may be received
Answer: B
Explanation:
Adviser contracts (Insurance Article, § 10-201) require fee amounts, contract duration, and commission disclosure for transparency. The consultant's license expiration is a regulatory detail, not a client contract requirement.
References:Maryland Insurance Article, § 10-201; MIA adviser rules.
NEW QUESTION # 17
All of the following are common features found in health maintenance organizations (HMOs) EXCEPT:
- A. Outpatient medical services
- B. Wellness programs
- C. Twenty-four hour access to emergency care
- D. Discounts on local health spa memberships
Answer: D
Explanation:
HMOs (Health-General Article, § 19-701) offer wellness, emergency, and outpatient services. Discounts on spa memberships aren't a standard feature, unrelated to core health care delivery.
References:Maryland Health-General Article, § 19-701; MIA HMO standards.
NEW QUESTION # 18
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