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

Section	Objectives
Topic 1: Accident and Health Insurance	- Policy provisions 1. Exclusions and limitations 2. Coordination of benefits - Health insurance types 1. Long-term care insurance 2. Disability income insurance 3. Medical expense insurance
Topic 2: Life Insurance	- Life insurance policies 1. Term life insurance 2. Whole life insurance 3. Universal life insurance - Policy provisions and riders 1. Beneficiaries and settlements 2. Policy loans and dividends
Topic 3: General Insurance Concepts	- Insurance principles and risk management 1. Risk types and management methods 2. Insurance contract fundamentals
Topic 4: State Law and Regulations	- Insurance producer regulations 1. Ethics and fiduciary duties 2. Licensing requirements

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Insurance Licensing Life and Accident and Health or Sickness Producer - Combo Series 20-30 Sample Questions (Q257-Q262):

NEW QUESTION # 257
An insured incurs a covered accident and health insurance loss on May 30, which is submitted to the insurer on June 8. If the insured terminated coverage on June 1, the insurer:

A. Can refuse to pay the claim because coverage has been terminated
B. Must pay the claim upon receipt of the proof of loss
C. Can refuse to pay the claim under the pre-existing conditions exclusion
D. Must pay the claim within one year of termination of coverage

Answer: B

Explanation:
A loss on May 30, while covered (Insurance Article, § 15-201), obligates the insurer to pay upon proof, despite termination on June 1. Termination or pre-existing exclusions don't negate prior coverage, and no one- year rule applies.
References:Maryland Insurance Article, § 15-201; MIA claims rules.

NEW QUESTION # 258
How many days does a former employee have to convert a group term policy to an individual policy after employment is terminated?

A. 0
B. 1
C. 2
D. 3

Answer: B

Explanation:
Under Maryland insurance law, a terminated employee has 31 days (D) to convert a group term life insurance policy into an individual policy without providing evidence of insurability.
This grace period allows individuals to maintain coverage while securing individual insurance.
10 (A), 20 (B), or 30 days (C) are incorrect, as Maryland mandates a specific 31-day window.
References: Maryland Conversion Rights in Group Life Insurance Policies, Section 15-401 of the Insurance Article.

NEW QUESTION # 259
A health maintenance organization (HMO) must provide coverage for all of the following EXCEPT:

A. Routine physical examinations
B. Emergency services
C. Dental and vision care
D. Well-baby or well-child care

Answer: C

Explanation:
Maryland HMOs (Health-General Article, § 19-701) must provide basic health services like routine physicals, well-child care, and emergency services. Dental and vision care, however, are not required unless specified as supplemental benefits. State law mandates pediatric care but excludes routine dental and vision from standard HMO coverage unless the plan explicitly includes them.
References:Maryland Health-General Article, § 19-701; Insurance Article, § 15-1201; MIA HMO guidelines.

NEW QUESTION # 260
All of the following statements about universal life insurance are true EXCEPT:

A. The Internal Revenue Code places a minimum limitation on the difference between the cash value and the death benefit
B. Withdrawals of the policy cash value are permitted and sometimes subject to a surrender charge
C. Failure to pay the renewal premium automatically causes the policy to lapse
D. It may be written with either a level death benefit or an increasing death benefit

Answer: C

Explanation:
Universal life insurance policies offer flexibility and adaptability, but they also have specific rules:
Minimum cash value vs. death benefit (A): Correct. IRS rules require a minimum difference to maintain tax- advantaged status.
Level or increasing death benefits (B): Correct. Policyholders can choose based on their needs.
Cash value withdrawals (C): Correct. Withdrawals are allowed but may incur surrender charges.
Automatic lapse (D): Incorrect. Universal life does not immediately lapse due to missed payments; instead, costs are deducted from the cash value, and the policy remains in force until the cash value is depleted.
References: Maryland Insurance Administration Policy Lapse Guidelines, IRS Tax Code §7702, and COMAR
31.09.13.

NEW QUESTION # 261
An insurance agent ' s license may be revoked for all of the following reasons EXCEPT:

A. Violating any insurance statute or regulation
B. Having no insurer appointment in effect for ten days
C. Having been found guilty of rebating
D. Being convicted of a felony

Answer: B

Explanation:
An agent's license can be revoked for serious infractions that violate Maryland's insurance laws:
Rebating (B): Prohibited under Maryland's Unfair Trade Practices Act.
Felony conviction (C): Grounds for revocation as it questions the agent's moral character.
Violating insurance statutes or regulations (D): Includes infractions such as fraud, misrepresentation, or failure to meet ethical standards.
Having no insurer appointment for ten days (A): Incorrect. A lack of appointment does not constitute a violation; it only affects the ability to conduct business temporarily.
References: Maryland Insurance Article §10-126, COMAR 31.03.02, and Licensing Enforcement Guidelines.

NEW QUESTION # 262
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