[Nov-2025] Maryland Insurance Administration Accident-and-Health-or-Sickness-Producer Exam: Basic Questions With Answers
New 2025 Realistic Free Maryland Insurance Administration Accident-and-Health-or-Sickness-Producer Exam Dump Questions and Answer
NEW QUESTION # 42
In Maryland, an insurance producer is a person who solicits, negotiates, or sells insurance plans PRIMARILY in conjunction with:
- A. Performing clerical duties
- B. Earning commission
- C. Acting as a regularly salaried officer
- D. Enrolling individuals in group plans
Answer: B
Explanation:
A producer (Insurance Article, § 1-101(aa)) solicits and sells insurance primarily for commissions, distinguishing them from clerical staff, enrollment facilitators, or salaried insurer employees. This reflects their independent role.
References:Maryland Insurance Article, § 1-101(aa), § 10-101; MIA producer definitions.
NEW QUESTION # 43
In general practice, can the Maryland Insurance Administration inspect the business records of an insurance company or agency?
- A. No, because of privacy considerations
- B. Yes, because of the powers defined by state laws
- C. No, because only an officer of the court can inspect these records
- D. Yes, because all company and agency records are public domain
Answer: B
Explanation:
Comprehensive and Detailed Step by Step Explanation:The Maryland Insurance Administration (MIA) is authorized to inspect the records of insurers and agencies to ensure compliance with laws:
Yes, because of the powers defined by state laws (B):Correct. The MIA has broad authority under Maryland law to audit, inspect, and investigate insurance business practices.
No, because of privacy considerations (A):Incorrect. Regulatory inspections are exempt from privacy concerns when conducted lawfully.
Only an officer of the court (C):Not required; the MIA operates independently within its legal mandate.
Public domain records (D):Incorrect; insurance records are not publicly accessible unless required by law.
References:Maryland Insurance Article §2-209, COMAR 31.03.01, and Regulatory Oversight Guidelines.
NEW QUESTION # 44
When an accident and health insurer requires a covered individual to undergo a physical examination, who pays the cost of the examination?
- A. The patient or parent of the patient
- B. The premium payor
- C. The principal insured individual
- D. The insurer
Answer: D
Explanation:
If an insurer mandates a physical exam (Insurance Article, § 12-202), it pays the cost, as it's a condition of coverage or claims processing. The premium payor, insured, or patient isn't responsible for insurer-initiated requirements.
References:Maryland Insurance Article, § 12-202; MIA policy standards.
NEW QUESTION # 45
An elimination period in a disability income insurance policy is the:
- A. Same as the probationary period
- B. Period between the start of a disability and the beginning of benefits
- C. Time period the policy is in force
- D. Time during which benefits are paid under the policy
Answer: B
Explanation:
The elimination period (Insurance Article, § 15-201) is the waiting time (e.g., 90 days) before disability benefits begin, distinct from the benefit period (payment duration), probationary period (pre-coverage wait), or policy term.
References:Maryland Insurance Article, § 15-201; MIA disability insurance rules.
NEW QUESTION # 46
To be eligible for major medical extended care benefits, a patient must:
- A. Be terminally ill
- B. Require physical therapy
- C. Have had surgery
- D. Require continuous skilled nursing care
Answer: D
Explanation:
Extended care under major medical (Insurance Article, § 15-201) requires continuous skilled nursing care (e.
g., nursing home), not just terminal illness, surgery, or therapy, which have broadercriteria.
References:Maryland Insurance Article, § 15-201; MIA major medical standards.
NEW QUESTION # 47
Which statement is true of trade association groups eligible for group medical benefits?
- A. Members of the association are usually in the same industry
- B. Employer contributions are usually waived
- C. The association membership primarily consists of large employers
- D. Such associations are formed for the purpose of purchasing insurance
Answer: A
Explanation:
Trade associations (Insurance Article, § 15-1209) group members in the same industry for medical benefits, not solely for insurance, and include small employers with contributions typically required.
References:Maryland Insurance Article, § 15-1209; MIA group insurance rules.
NEW QUESTION # 48
All of the following services are covered under the Medicare Supplement preventive care benefit EXCEPT:
- A. Immunizations
- B. Routine physical examinations
- C. Outpatient prescription vitamins
- D. Hearing tests
Answer: C
Explanation:
Medicare Supplement (Medigap, Insurance Article, § 15-901) covers preventive services like immunizations, hearing tests (if Medicare-eligible), and physicals, but outpatient prescription vitamins aren't a standard benefit under Medicare or Medigap.
References:Maryland Insurance Article, § 15-901; CMS Medigap guidelines.
NEW QUESTION # 49
When a single major medical contract covers all medical expenses, the plan is considered to be:
- A. First-dollar
- B. Comprehensive
- C. Supplemental
- D. Limited
Answer: B
Explanation:
A single policy covering all medical expenses (Insurance Article, § 15-201) is comprehensive, unlike limited (specific), first-dollar (no deductible), or supplemental (add-on) plans.
References:Maryland Insurance Article, § 15-201; MIA major medical standards.
NEW QUESTION # 50
An insurer may pay a commission directly or indirectly to:
- A. A producer whose license is terminated after earning the commission
- B. A surplus lines broker operating without a license for less than one year
- C. An unlicensed employee of the insurer
- D. Anyone soliciting business for the insurer
Answer: A
Explanation:
Commissions (Insurance Article, § 10-103) require a license, but a producer earning a commission while licensed can be paid post-termination. Unlicensed individuals or brokers can't legally receive commissions.
References:Maryland Insurance Article, § 10-103, § 10-130, § 3-306; MIA commission rules.
NEW QUESTION # 51
When the insured's willful failure to disclose a material fact at the time of application is discovered by the insurer shortly after the policy is issued:
- A. The policy is voidable at the insurer's option
- B. The insurer may cancel the policy only at the expiration or renewal date
- C. The policy is automatically void
- D. The insurer must continue the insurance policy in full force
Answer: A
Explanation:
A material misrepresentation (Insurance Article, § 12-206) allows the insurer to void the policy within the contestability period (typically 2 years) if willful. It's not automatically void, nor must it continue or wait until renewal; the insurer decides based on materiality.
References:Maryland Insurance Article, § 12-206; MIA misrepresentation rules.
NEW QUESTION # 52
All of the following are examples of unfair claims settlement practices EXCEPT:
- A. Misrepresenting pertinent facts of coverage
- B. Failing to promptly provide a reason for a claim denial
- C. Refusing arbitrarily and unreasonably to pay claims
- D. Denying unsubstantiated claims on a timely basis
Answer: D
Explanation:
Unfair practices (Insurance Article, § 27-303) include delays, arbitrary refusals, and misrepresentation.
Denying unsubstantiated claims promptly is fair and expected, not an unfair practice.
References:Maryland Insurance Article, § 27-303; MIA claims regulations.
NEW QUESTION # 53
An insurance producer provided several examples to the applicant persuasively demonstrating that the insurance coverage offered under his company's policy was superior to a competitor's product. The insurance producer knew he was misrepresenting or stretching the truth in order to induce the applicant to forfeit her current policy and purchase a similar but inferior insurance policy from him. The insurance producer is involved in which one of the following unfair trade practices?
- A. Twisting
- B. Rebating
- C. Discrimination
- D. Fraud
Answer: A
Explanation:
Twisting (Insurance Article, § 27-203) involves misrepresenting policy benefits to induce replacement with an inferior product. Fraud is broader, discrimination isn't relevant, and rebating offers financial inducements, not misrepresentation.
References:Maryland Insurance Article, § 27-203; MIA trade practice rules.
NEW QUESTION # 54
An insurance producer or advisor in the State of Maryland can be disciplined by the MarylandInsurance Administration for all of the following EXCEPT:
- A. Filing a complaint on behalf of the consumer with the Maryland Insurance Administration
- B. Making a misleading statement about the financial condition of an insurer
- C. Using inappropriate description of a policy to hide the true nature of the policy
- D. Making false or misleading statements about dividends previously paid on similar policies
Answer: A
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 # 55
Which type of Medicare Supplement information can be used without prior state approval?
- A. Radio announcements approved by the insurer
- B. Insurance company brochures
- C. Television advertisements approved by the insurer
- D. Government publications
Answer: D
Explanation:
Medigap marketing materials (Insurance Article, § 15-912) require MIA approval, except for government publications (e.g., CMS's "Medicare & You"), which are exempt as official federal resources. Insurer- approved ads still need state review.
References:Maryland Insurance Article, § 15-912; MIA Medigap advertising rules.
NEW QUESTION # 56
The Maryland Health Insurance Plan is designed to provide comprehensive health benefits for:
- A. Medically uninsurable Maryland residents
- B. Children of low-income Maryland residents
- C. Senior citizens residing in Maryland
- D. Low-income residents of Maryland
Answer: A
Explanation:
The Maryland Health Insurance Plan (MHIP, Insurance Article, § 15-1301) historically provided coverage for medically uninsurable residents rejected by private insurers, until phased out in 2014 by the ACA. It didn't target low-income (Medicaid), seniors (Medicare), or children (CHIP) specifically.
References:Maryland Insurance Article, § 15-1301 (historical); MIA MHIP documentation.
NEW QUESTION # 57
Coverage for the first three pints of blood for Medicare enrollees is:
- A. A Medicare Part B benefit
- B. A Medicare Part A benefit
- C. A Medicare Supplement core benefit
- D. A Medicare Supplement additional benefit
Answer: C
Explanation:
Medicare Part A excludes the first three pints of blood for inpatient care, but Medigap core benefits (Insurance Article, § 15-901) cover this cost across all plans (A-J), making it a standard, not additional, benefit. Parts A and B don't include it directly.
References:Maryland Insurance Article, § 15-901; CMS Medicare guidelines.
NEW QUESTION # 58
In dental insurance coverage, which one of the following typically is EXCLUDED?
- A. Root canal therapy
- B. Preventive care
- C. Dental X-rays
- D. Treatment started prior to the eligibility date
Answer: D
Explanation:
Dental insurance (Insurance Article, § 15-201) covers preventive care, X-rays, and root canals, but excludes treatment started before the eligibility date to avoid claims for pre-existing work. This ensures coverage applies only to services initiated under the policy.
References:Maryland Insurance Article, § 15-201; MIA dental insurance standards.
NEW QUESTION # 59
Which expenses are covered by Medicare Part D?
- A. Hospital
- B. Prescription drug
- C. Medical
- D. Dental
Answer: B
Explanation:
Medicare Part D covers outpatient prescription drugs, not medical (Part B), hospital (Part A), or dental (excluded) expenses, per federal law applicable in Maryland. It fills a key gap for enrollees' medication costs.
References:Medicare guidelines; Maryland Insurance Article, § 15-901.
NEW QUESTION # 60
All of the following factors may affect premium determination in individual life insurance EXCEPT:
- A. Health
- B. Race
- C. Age
- D. Occupation
Answer: B
Explanation:
Comprehensive and Detailed Step by Step Explanation:Premium determination in life insurance depends on factors that measure risk, butrace (D)is not and cannot be used due to anti-discrimination laws.
Age (A):A primary factor; younger applicants are charged lower premiums due to lower mortality risk.
Health (B):Significant; poor health or pre-existing conditions increase premiums.
Occupation (C):Risky professions (e.g., construction or aviation) may result in higher premiums.
Race (D):Prohibited by Maryland law, which ensures fairness and prohibits underwriting based on race, ethnicity, or similar discriminatory criteria.
References:Maryland Insurance Article §27-501, COMAR 31.09.03, and Anti-Discrimination Standards in Insurance.
NEW QUESTION # 61
A nonprofit health service plan may NOT issue a contract that covers which of the following types of benefits?
- A. Dental benefits
- B. Disability income benefits
- C. Vision benefits
- D. Medical expense benefits
Answer: B
Explanation:
Nonprofit health service plans (Insurance Article, § 14-102), like HMOs, provide medical, vision, and dental benefits, but disability income-replacing lost wages-is outside their scope and belongs to separate insurance types.
References:Maryland Insurance Article, § 14-102; MIA nonprofit plan rules.
NEW QUESTION # 62
When determining the premiums for large groups, most insurance companies use:
- A. Experience rating
- B. Area rating
- C. Pooled rating
- D. Occupational rating
Answer: A
Explanation:
Large group premiums (Insurance Article, § 15-1205) use experience rating, basing rates on the group's claims history. Occupational rating applies to specific jobs, area rating to geography, and pooled rating to small groups, none of which dominate large groups.
References:Maryland Insurance Article, § 15-1205; MIA group insurance guidelines.
NEW QUESTION # 63
A health maintenance organization may issue a contract that provides benefits for the following:
- A. Replacement of income lost by a member due to the member's disability
- B. Health care services provided to members of the HMO
- C. The accidental death of an HMO member
- D. The dismemberment of an HMO member
Answer: B
Explanation:
HMOs (Health-General Article, § 19-701) provide health care services to members, not income replacement (disability insurance), accidental death, or dismemberment benefits (life/accident insurance).
References:Maryland Health-General Article, § 19-701; MIA HMO guidelines.
NEW QUESTION # 64
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