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

SectionObjectives
State Law and Regulations- Insurance producer regulations
  • 1. Ethics and fiduciary duties
    • 2. Licensing requirements
      Life Insurance- Policy provisions and riders
      • 1. Beneficiaries and settlements
        • 2. Policy loans and dividends
          - Life insurance policies
          • 1. Term life insurance
            • 2. Whole life insurance
              • 3. Universal life insurance
                General Insurance Concepts- Insurance principles and risk management
                • 1. Risk types and management methods
                  • 2. Insurance contract fundamentals
                    Accident and Health Insurance- Policy provisions
                    • 1. Exclusions and limitations
                      • 2. Coordination of benefits
                        - Health insurance types
                        • 1. Disability income insurance
                          • 2. Long-term care insurance
                            • 3. Medical expense insurance

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                              Insurance Licensing Life and Accident and Health or Sickness Producer - Combo Series 20-30 Sample Questions (Q107-Q112):

                              NEW QUESTION # 107
                              The reinstatement provision in individual accident and health insurance:

                              Answer: D

                              Explanation:
                              Comprehensive and Detailed in Depth Explanation:
                              The correct answer is B. Allows the insured to reinstate the policy after coverage lapses for nonpayment of premium. Under Maryland Insurance Article §15-210, each health insurance policy must contain a reinstatement provision. If a renewal premium is not paid within the time allowed, later acceptance of the premium by the insurer or an authorized insurance producer can reinstate the policy. If an application for reinstatement is required, the policy is reinstated when the insurer approves the application or, if the insurer does not disapprove it in writing, on the 45th day after the conditional receipt. This provision is about restoring a lapsed policy, not restoring the face amount after a claim, changing application statements, or requiring approval from the Maryland Insurance Administration. Official Maryland Reference: Maryland Insurance Article §15-210, Reinstatement.


                              NEW QUESTION # 108
                              All of the following are underwriting criteria for individual life insurance EXCEPT:

                              Answer: D

                              Explanation:
                              Purpose of underwriting criteria.
                              Underwriting criteria must relate to risk assessment or policy performance.
                              Permissible factors.
                              Gender: Historically used where actuarially justified.
                              Occupation: Reflects hazard exposure.
                              Ability to pay premiums: Ensures policy sustainability.
                              Prohibited factors.
                              Religion is a protected characteristic and cannot be used in underwriting.
                              Maryland anti-discrimination rules.
                              Maryland prohibits unfair discrimination unrelated to actuarial risk.
                              Conclusion.
                              Religion is not a lawful underwriting criterion.


                              NEW QUESTION # 109
                              All of the following are true of insurance EXCEPT:

                              Answer: B

                              Explanation:
                              Insurance (Insurance Article, § 1-101) transfers risk, shares losses, and protects against uncertainty, but it mitigates, not eliminates, risk, which remains inherent.
                              References:Maryland Insurance Article, § 1-101; MIA insurance basics.


                              NEW QUESTION # 110
                              Which medical care benefits are emphasized in HMO plans?

                              Answer: C

                              Explanation:
                              Comprehensive and Detailed in Depth Explanation:
                              The correct answer isB. Preventive care. Health Maintenance Organizations, or HMOs, are designed around managed care, network-based care, and controlling costs by encouraging early treatment, wellness, and prevention. Maryland's Health-General Article requires an HMO's plan to show that it has an active program forpreventing illness, disability, and hospitalizationamong its members, and that services designed to prevent major health problems and improve general health are provided by the HMO.
                              Emergency care, home health care, and other services may be covered under appropriate circumstances, but they are not the primary medical care benefit emphasized by the HMO model. Alternative medicine is not the core HMO emphasis. Official Maryland Reference: Maryland Health-General Article §19-705.1, HMO quality of care and preventive programs.


                              NEW QUESTION # 111
                              An insured's statements on an accident and health insurance application are deemed to be:

                              Answer: B

                              Explanation:
                              Statements on applications (Insurance Article, § 12-206) are representations-factual assertions to the best of the insured's knowledge-where only material misrepresentations void a policy. Warranties are stricter and less common, while categorical and general provisions don't apply.
                              References:Maryland Insurance Article, § 12-206; MIA application rules.


                              NEW QUESTION # 112
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