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| Section | Weight | Objectives |
|---|---|---|
| Topic 1: Social Insurance Programs | 8-12% | - Social Security disability benefits - CHIP (Children's Health Insurance Program) - Medicare Part A, B, C, D - Medicaid programs |
| Topic 2: Field Underwriting and Application Process | 8-12% | - Risk classification - Agent responsibilities in enrollment - Medical underwriting - Application procedures |
| Topic 3: Maryland Insurance Laws and Regulations | 20-25% | - Unfair claim settlement practices - Producer licensing requirements - Privacy and confidentiality requirements - Maryland Insurance Code - Violations and penalty provisions - Consumer protection regulations |
| Topic 4: Policy Provisions and Clauses | 18-22% | - Benefit periods - Coverage terms and conditions - Preexisting condition clauses - Waiting periods - Deductibles and copayments - Exclusions and limitations |
| Topic 5: Types of Health Insurance Policies | 20-25% | - Individual health insurance - Long-term care insurance - Medicare and Medicaid - Dental and vision insurance - Group health insurance - Disability income insurance |
| Topic 6: Marketing Practices | 8-12% | - Marketing regulations - Prohibited practices - Advertising guidelines - Producer responsibilities |
1. Group health insurance contracts providing coverage for employees in more than one state are usually controlled by the laws of the state where:
A) The majority of employees reside
B) The master contract is issued
C) The producer resides
D) The application is signed
2. A health maintenance organization (HMO) must provide coverage for all of the following EXCEPT:
A) Routine physical examinations
B) Well-baby or well-child care
C) Emergency services
D) Dental and vision care
3. A certificate of insurance in a group accident and health plan is:
A) A binding contract between the employer and the insurer
B) Issued to the employer for each insured location
C) Evidence of the employee's insurance coverage
D) A binding contract between the employee and the insurer
4. The typical group disability income insurance policy EXCLUDES coverage for disability resulting from:
A) Commercial airline crashes
B) Automobile accidents
C) Injuries occurring in the home
D) Military service
5. Which one of the following causes of loss typically is EXCLUDED under a disability income insurance policy?
A) Cancer
B) Intentionally self-inflicted injuries
C) Auto accidents
D) Tropical disease
Solutions:
| Question # 1 Answer: B | Question # 2 Answer: D | Question # 3 Answer: C | Question # 4 Answer: D | Question # 5 Answer: B |
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