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

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

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Insurance Licensing Life and Accident and Health or Sickness Producer - Combo Series 20-30 Sample Questions (Q70-Q75):

NEW QUESTION # 70
If an employer with 200 employees wants to offer health insurance and calls a SHOP Exchange Navigator, what should the navigator do?

A. Refer the employer to the Maryland Insurance Administration
B. Refer the employer to the carrier where a friend works
C. Help the employer sign-up through the SHOP Exchange
D. Refer the employer to a licensed insurance producer

Answer: D

Explanation:
SHOP Exchange (Insurance Article, § 31-101) serves employers with 1-50 employees; a 200-employee firm exceeds this, so the navigator should refer them to a producer for large group plans, not assist via SHOP, refer personally, or send to the MIA.
References:Maryland Insurance Article, § 31-101; MIA SHOP Exchange guidelines.

NEW QUESTION # 71
Which type of coverage bases benefit eligibility on the capacity to perform activities of daily living?

A. Long-term care insurance
B. Medicare supplement
C. Major medical expense
D. Long-term disability

Answer: A

Explanation:
Long-term care insurance (Insurance Article, § 18-101) triggers benefits based on inability to perform ADLs (e.g., bathing), unlike Medigap, major medical, or disability, which focus on medical or work criteria.
References:Maryland Insurance Article, § 18-101; MIA long-term care rules.

NEW QUESTION # 72
All of the following are true of insurance EXCEPT:

A. It is a means of sharing losses
B. It eliminates risk
C. It transfers risk
D. It protects against uncertainty

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 # 73
Which life annuity contract feature provides that benefit payments will continue for a minimum number of years regardless of when the annuitant dies?

A. Cash refund
B. Period certain
C. Installment refund
D. Cost recovery

Answer: B

Explanation:
A "period certain" provision ensures payment for a specified period regardless of whether the annuitant survives:
Period certain (B) guarantees payments for a set number of years, protecting beneficiaries.
Cost recovery (A) and refund options (C and D) relate to refunding premiums or unpaid amounts but do not guarantee a payment period.
References: Maryland Annuity Regulations, Payment Options.

NEW QUESTION # 74
Which activity is an unfair claims settlement practice?

A. Offering settlements that are less than the fair value to offset insurer expenses
B. Including an arbitration provision in the insurer ' s policies
C. Negotiating the payment of claims where coverage or liability is in question
D. Denying claims on the basis of specific policy provisions

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 # 75
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