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| Section | Weight | Objectives |
|---|---|---|
| Topic 1: Accident and Health / Sickness Insurance | 20% | - Mandatory benefits and state-specific health rules - Health insurance basics and policy provisions - HMO, PPO, group vs individual coverage - Disability income, medical expense, and long-term care |
| Topic 2: General Insurance Concepts | 15% | - Underwriting, premium calculation, and taxation - Insurable interest and risk management - Contract law and principles |
| Topic 3: Annuities and Retirement Products | 10% | - Fixed, indexed, and variable annuities - Tax treatment and suitability standards |
| Topic 4: Insurance Regulation | 30% | - Ethics, unfair trade practices, and consumer protection - Policy delivery, replacement rules, and disclosure - State insurance laws and Maryland regulations - Licensing requirements and procedures |
| Topic 5: Life Insurance Basics and Policies | 25% | - Policy provisions, riders, and options - Beneficiaries, claims, and settlement options - Types of life insurance: term, whole, universal, variable |
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NEW QUESTION # 195
Prescription drug plans sometimes control expenses by encouraging the use of:
Answer: B
Explanation:
Comprehensive and Detailed in Depth Explanation:
Prescription drug plans commonly control costs by encouraging members to usegeneric drugs. The Maryland Insurance Administration explains that prescription drug coverage often uses aformulary, or list of covered drugs, arranged by tiers. In Maryland's consumer guidance,Tier 1 is generic drugs, and these are described as
"lower-cost drugs," while preferred and non-preferred brand-name drugs are placed in higher tiers and generally cost more. Therefore, the correct answer isC. Generic drugs.
A "legend drug" simply means a drug that generally requires a prescription; it does not specifically identify the lower-cost option. "Federally approved drugs" is too broad because both generic and brand-name drugs may be federally approved. "Brand-name drugs" are usually more expensive than generic drugs, so encouraging brand-name drugs would not typically be the cost-control method tested here. Official Maryland Reference: Maryland Insurance Administration, prescription drug coverage and formulary tiers.
NEW QUESTION # 196
In order to qualify for a company convention, an insurance producer agrees to pay the first quarterly premium for the applicant for new insurance. This is called a:
Answer: A
Explanation:
Paying an applicant's premium is considered a rebate, which is generally prohibited in Maryland unless explicitly permitted by law.
Rebates (B) involve offering inducements not specified in the policy, which can undermine fairness and market stability.
Gifts (A) and loans (C) imply separate intentions and are distinct from policy-related payments.
Cost of doing business (D) does not apply, as paying premiums on behalf of clients violates anti-rebating laws.
References: Maryland Rebating Laws, Unfair Trade Practices Act.
NEW QUESTION # 197
All of the following are basic underwriting actions in accident and health insurance EXCEPT:
Answer: B
Explanation:
Underwriting involves assessing risk by rejecting high-risk applicants, issuing standard policies, or adding exclusion riders for specific conditions. Deleting uniform policy provisions-mandatory clauses like grace periods (Insurance Article, § 15-201)-isn't an underwriting action, as these are legally required and cannot be altered by underwriters.
References:Maryland Insurance Article, § 15-201 et seq.; MIA underwriting guidelines.
NEW QUESTION # 198
All of the following are common features found in health maintenance organizations (HMOs) EXCEPT:
Answer: A
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 # 199
(If all beneficiaries die before the insured dies, the proceeds of a life insurance policy will be paid to:)
Answer: D
Explanation:
Comprehensive and Detailed Step by Step Explanation:
* Life insurance proceeds go to a living beneficiary:Policies normally pay to the named beneficiary (primary/contingent) if living.
* If no beneficiary survives:If all named beneficiaries predecease the insured (and no valid contingent beneficiaries remain), the policy typically pays to theinsured's estate.
* Why C is correct:The estate becomes the recipient when there is no surviving beneficiary designation.
* Why others are wrong:
* A: Creditors are not the default recipient (they may have claims against the estate depending on probate law, but payment is to the estate).
* B: Courts don't "name" a new beneficiary as the default; the estate is standard.
* D: The beneficiary's estate is not typically entitled unless the beneficiary survived the insured (or specific policy language/settlement option applies).
* Maryland reference (claims-handling fairness concept):Any payout decision must follow the policy terms; failing to clearly explain payment basis or misrepresenting who is entitled would implicate Maryland's requirements to avoid misrepresentation and to provide reasonable explanations.
NEW QUESTION # 200
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