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Interactive Accident-and-Health-or-Sickness-Producer Practice Exam - Test Accident-and-Health-or-Sickness-Producer Simulator Online

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Maryland Insurance Administration MarylandAccident and Health or Sickness Producer Series 20-24 Exam Sample Questions (Q26-Q31):

NEW QUESTION # 26
The entire contract provision in an individual accident and health insurance policy states that the producer:

A. May waive only certain contract provisions
B. Has no authority to change the policy or waive any of its provisions
C. Has company authority to change the policy
D. Has company authority to waive any contract provisions

Answer: B

Explanation:
The entire contract provision (Insurance Article, § 15-207) defines the policy and application as the full agreement, barring producers from altering or waiving terms. Only the insurer has such authority.
References:Maryland Insurance Article, § 15-207; MIA policy standards.

NEW QUESTION # 27
Medical expense insurance typically EXCLUDES coverage for:

A. Expenses incurred for primarily cosmetic surgery
B. Maternity care benefits
C. Hospital laboratory tests
D. Hospital care extending past 30 days

Answer: A

Explanation:
Medical expense insurance covers necessary treatments like hospital stays, maternity care, and diagnostic tests, but excludes elective procedures such as primarily cosmetic surgery unless medically necessary (e.g., reconstructive surgery post-injury). Maryland law (Insurance Article, § 15-103) allows exclusions for non- essential services, aligning with standard practice where aesthetic surgeries like facelifts are not covered.
References:Maryland Insurance Article, § 15-103; MIA guidelines.

NEW QUESTION # 28
All of the following are common features found in health maintenance organizations (HMOs) EXCEPT:

A. Discounts on local health spa memberships
B. Wellness programs
C. Outpatient medical services
D. Twenty-four hour access to emergency care

Answer: A

Explanation:
HMOs (Health-General Article, § 19-701) offer wellness, emergency, and outpatient services. Discounts on spa memberships aren't a standard feature, unrelated to core health care delivery.
References:Maryland Health-General Article, § 19-701; MIA HMO standards.

NEW QUESTION # 29
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 # 30
Medical expense insurance typically EXCLUDES coverage for treatment of:

A. Intentionally self-inflicted injuries
B. Chronic back pain
C. Undiagnosed diseases
D. Eating disorders

Answer: A

Explanation:
Medical expense insurance covers necessary treatments like chronic pain, eating disorders (under parity laws,
§ 15-802), and undiagnosed conditions if treated, but excludes intentionally self-inflicted injuries (e.g., suicide attempts) as non-accidental losses (Insurance Article, § 15-201).
References:Maryland Insurance Article, § 15-201, § 15-802; MIA health insurance exclusions.

NEW QUESTION # 31
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