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Maryland Insurance Administration MarylandAccident and Health or Sickness Producer Series 20-24 Exam Sample Questions (Q67-Q72):

NEW QUESTION # 67
A health maintenance organization (HMO) must provide coverage for all of the following EXCEPT:

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

Answer: B

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 # 68
Which of the following is NOT a mandated benefit in Maryland?

A. Hearing aids for children
B. Weight reduction programs
C. Treatment of substance abuse
D. Treatment of mental illness

Answer: B

Explanation:
Maryland mandates mental health (§ 15-802), substance abuse (§ 15-803), and hearing aids for children (§ 15-
838), but weight reduction programs are elective and not required (Insurance Article, § 15-801).
References:Maryland Insurance Article, § 15-801, § 15-802, § 15-803, § 15-838; MIA mandated benefits.

NEW QUESTION # 69
Which type of coverage bases benefit eligibility on the capacity to perform activities of daily living?

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

Answer: B

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 # 70
Which one of the following causes of death typically would be included under an accidental death rider attached to a life insurance policy?

A. Intentionally self-inflicted injuries
B. War or acts of war
C. Illness or disease
D. Automobile accidents resulting from the insured's negligence

Answer: D

Explanation:
Comprehensive and Detailed Step by Step Explanation:Accidental death riders provide additional benefits if the insured dies due to an unforeseen accident.
* Automobile accidents resulting from the insured's negligence (D):Covered because negligence in driving does not disqualify the event from being an accident. The death must be directly and solely caused by the accident.
* Intentionally self-inflicted injuries (A):Excluded as they are not accidental but intentional.
* Illness or disease (B):Excluded as accidental death benefits do not apply to natural causes.
* War or acts of war (C):Generally excluded under most policies as a specific clause addresses wartime risks.
References:Maryland Insurance Guidelines for Accidental Death Riders and Policy Exclusions, COMAR
31.09.04.

NEW QUESTION # 71
An insurance producer or advisor in the State of Maryland can be disciplined by the MarylandInsurance Administration for all of the following EXCEPT:

A. Making false or misleading statements about dividends previously paid on similar policies
B. Using inappropriate description of a policy to hide the true nature of the policy
C. Filing a complaint on behalf of the consumer with the Maryland Insurance Administration
D. Making a misleading statement about the financial condition of an insurer

Answer: C

Explanation:
The MIA (Insurance Article, § 10-126) disciplines producers for misrepresentation (§ 27-202, § 27-503), but filing a consumer complaint with the MIA is a legitimate advocacy action, not a disciplinary offense. It supports consumer protection, unlike the other deceptive practices.
References:Maryland Insurance Article, § 10-126, § 27-202, § 27-503; MIA producer regulations.

NEW QUESTION # 72
......

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Maryland Insurance Administration MarylandAccident and Health or Sickness Producer Series 20-24 Exam Sample Questions (Q67-Q72):

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