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Insurance Licensing Life-and-Accident-and-Health-or-Sickness-Producer-Combo Exam Syllabus Topics:

SectionWeightObjectives
Topic 1: Accident and Health / Sickness Insurance20%- 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 Concepts15%- Contract law and principles
- Underwriting, premium calculation, and taxation
- Insurable interest and risk management
Topic 3: Life Insurance Basics and Policies25%- Beneficiaries, claims, and settlement options
- Types of life insurance: term, whole, universal, variable
- Policy provisions, riders, and options
Topic 4: Insurance Regulation30%- State insurance laws and Maryland regulations
- Policy delivery, replacement rules, and disclosure
- Ethics, unfair trade practices, and consumer protection
- Licensing requirements and procedures
Topic 5: Annuities and Retirement Products10%- Tax treatment and suitability standards
- Fixed, indexed, and variable annuities

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Insurance Licensing Life and Accident and Health or Sickness Producer - Combo Series 20-30 Sample Questions (Q16-Q21):

NEW QUESTION # 16
Which activity is an unfair claims settlement practice?

Answer: A

Explanation:
Offering settlements below fair value (D) is prohibited as an unfair claims settlement practice under Maryland law. Insurers must handle claims in good faith and pay fair settlements based on policy terms.
Negotiating claims (A): Permitted when there are legitimate disputes over coverage or liability.
Denying claims (B): Allowed if based on valid policy exclusions or conditions.
Including arbitration provisions (C): Legal, provided they comply with state guidelines and are not coercive.
Unfair claims settlement practices include:
Misrepresenting policy provisions.
Failing to promptly investigate or settle claims.
Attempting to settle for less than reasonable amounts.
References: Maryland Insurance Article §27-303, Unfair Claims Practices Act, and COMAR 31.15.07.


NEW QUESTION # 17
Accident and health policies must cover physically or mentally handicapped dependent children:

Answer: C

Explanation:
Maryland law (Insurance Article, § 15-401) requires coverage for handicapped dependent children beyond standard age limits if they're incapable of self-sustaining employment and dependent on the insured. This extends for life, or as long as the policy is active, not limited to ages 19 or 25, nor tied to self-sustainability.
References:Maryland Insurance Article, § 15-401; MIA dependent coverage regulations.


NEW QUESTION # 18
The owner's cost basis in a non-qualified deferred annuity is usually equal to the:

Answer: D

Explanation:
Meaning of cost basis.
Cost basis represents the amount of after-tax money the owner has invested in the contract.
Non-qualified annuity definition.
A non-qualified annuity is purchased with after-tax dollars, not through a qualified retirement plan.
How cost basis is calculated.
The cost basis equals the sum of all premiums paid, minus any non-taxable withdrawals previously received.
Why this matters for taxation.
When distributions occur:
Earnings are taxable as ordinary income.
The cost basis portion is returned tax-free.
Evaluate each option.
A). Opportunity cost
An economic concept, not a tax basis.
B). Total premiums paid
Correct. This is the owner's investment in the contract.
C). Guaranteed cash value
A policy feature, not tax basis.
D). Actual cash value
Includes earnings, not just after-tax investment.
Conclusion.
The cost basis of a non-qualified annuity is the total premiums paid.


NEW QUESTION # 19
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 # 20
When a producer engages in unfair practices, all of the following are true EXCEPT:

Answer: B

Explanation:
Authority of the Maryland Insurance Administration (MIA).
The MIA has the authority to investigate complaints, conduct hearings, and impose disciplinary actions against licensed producers.
Evaluate each option.
A). Investigation and hearing
Correct. The MIA investigates alleged violations and may hold administrative hearings.
B). Decision is final
Incorrect. MIA decisions are subject to judicial review and appeal under Maryland administrative law.
C). License suspension
Correct. The MIA may suspend, revoke, or refuse to renew a producer's license.
Good-faith enforcement relevance.
Maryland's system ensures fairness by allowing producers due process and appeal rights.
Conclusion.
Because MIA decisions are not automatically final, option B is the correct answer.


NEW QUESTION # 21
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