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

SectionWeightObjectives
Accident and Health / Sickness Insurance20%- HMO, PPO, group vs individual coverage
- Mandatory benefits and state-specific health rules
- Disability income, medical expense, and long-term care
- Health insurance basics and policy provisions
Insurance Regulation30%- Policy delivery, replacement rules, and disclosure
- State insurance laws and Maryland regulations
- Ethics, unfair trade practices, and consumer protection
- Licensing requirements and procedures
Life Insurance Basics and Policies25%- Policy provisions, riders, and options
- Beneficiaries, claims, and settlement options
- Types of life insurance: term, whole, universal, variable
Annuities and Retirement Products10%- Fixed, indexed, and variable annuities
- Tax treatment and suitability standards
General Insurance Concepts15%- Insurable interest and risk management
- Contract law and principles
- Underwriting, premium calculation, and taxation

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Insurance Licensing Life and Accident and Health or Sickness Producer - Combo Series 20-30 Sample Questions (Q96-Q101):

NEW QUESTION # 96
In Maryland, a group accident and health certificate of insurance must contain:

Answer: C

Explanation:
Certificates (Insurance Article, § 15-1207) summarize policy features and benefits for group members, not the full contract, physician lists, or financial statements, which are separate or irrelevant. This ensures employees understand their coverage.
References:Maryland Insurance Article, § 15-1207; MIA group insurance rules.


NEW QUESTION # 97
(If a producer misleads or fails to adequately disclose the title and true nature of a policy offered to a potential insured, it may be considered:)

Answer: D

Explanation:
Comprehensive and Detailed Step by Step Explanation:
* What the conduct is:Misleading a consumer or failing to disclose the true nature/title of a policy is giving inaccurate or incomplete information about coverage.
* Correct concept:That behavior ismisrepresentation(false, misleading, or incomplete statements about policy terms/benefits).
* Why the other options don't fit:
* Defamation: harming someone's reputation with false statements-unrelated here.
* Unfair discrimination: treating similarly situated insureds differently in underwriting/pricing without lawful basis-different issue.
* Coercion: forcing someone to buy through threats/pressure-different issue.
* Maryland reference:Maryland explicitly prohibitsmisrepresenting pertinent facts or policy provisionsand includesincomplete or misleading disclosureas misrepresentation.


NEW QUESTION # 98
To be eligible for major medical extended care benefits, a patient must:

Answer: A

Explanation:
Extended care under major medical (Insurance Article, § 15-201) requires continuous skilled nursing care (e.
g., nursing home), not just terminal illness, surgery, or therapy, which have broadercriteria.
References:Maryland Insurance Article, § 15-201; MIA major medical standards.


NEW QUESTION # 99
A licensee must report each of the following to the Maryland Insurance Administration EXCEPT:

Answer: A

Explanation:
Insurance licensees in Maryland are required to report certain changes to the Maryland Insurance Administration (MIA):
Change of name (A): Must be reported promptly to ensure accurate licensure records.
Change of residence address (B): Also required for communication and compliance purposes.
Felony convictions (D): Mandatory disclosure to maintain transparency and evaluate fitness for licensure.
Change in financial status (C): Not required unless it directly affects the licensee's ability to meet financial obligations tied to the license (e.g., bonding requirements).
References: Maryland Insurance Code §10-118, COMAR 31.03.01.


NEW QUESTION # 100
Reasonable and customary charges for health care are based primarily on:

Answer: C

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 # 101
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