Pass the Insurance Licensing Maryland Insurance Accident-and-Health-or-Sickness-Producer Questions and answers with ExamsMirror

A waiting period (Insurance Article, § 15-109) delays coverage for pre-existing conditions (e.g., 6-12 months), not permanently excluding them, starting at inception, or holding payments in escrow.

Comprehensive and Detailed Step by Step Explanation:Misrepresentation involves providing false, misleading, or incomplete information about a policy:

Failed to disclose exclusions of the policy (A):Correct. Not informing the insured about policy exclusions misrepresents the coverage and violates Maryland law.

Denied a claim for failure to prove damages (B):This relates to claims handling and is not misrepresentation.

Required written notice of loss (C):This is a legitimate policy requirement, not misrepresentation.

Issued a full settlement check (D):Standard claims settlement practice when agreed upon; not related to misrepresentation.

Maryland law (Insurance Article, § 15-401) requires coverage for handicapped dependent children beyond standard age limits if they’re incapable of self-sustaining employment and dependent on the insured. This extends for life, or as long as the policy is active, not limited to ages 19 or 25, nor tied to self-sustainability.

Certificates (Insurance Article, § 15-1207) summarize policy features and benefits for group members, not the full contract, physician lists, or financial statements, which are separate or irrelevant. This ensures employees understand their coverage.

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.

Federal law (18 U.S.C. § 1033) criminalizes embezzlement by a producer, a felony punishable by prison if interstate commerce is affected. Nonresident licensing is a state issue, inducing applications is legal, and suing is a civil action, not criminal.

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.

Comprehensive and Detailed Step by Step Explanation:Aninsurable riskmust meet specific criteria to ensure fair and financially viable coverage:

Chance of loss must be calculable (C):Correct. Insurers need statistical data to assess risk and determine premiums.

Loss must be intentional (A):Incorrect; intentional losses are not insurable.

Loss must be catastrophic (B):Incorrect; catastrophic losses (e.g., war or large-scale disasters) are often excluded or managed through reinsurance.

Large number of different loss exposures (D):A large number of similar, not different, exposures is required for risk pooling.

Comprehensive and Detailed Step by Step Explanation:The Maryland Insurance Administration (MIA) has sole authority to regulate, suspend, or revoke an insurance producer’s license for violations of state insurance laws:

Maryland Insurance Administration (C):Correct. The MIA oversees producer licensing, compliance, and disciplinary actions.

Appointing insurer (A):Can terminate an appointment but cannot revoke a license.

Continuing education provider (B):Only offers training and has no regulatory authority.

Attorney General (D):Handles legal actions but does not directly manage licensing.

The Maryland Benchmark Plan (Insurance Article, § 31-115) defines EHBs for individual and small group plans sold via the Maryland Health Connection Exchange, not Medicaid, Medigap, or pre-2014 off-Exchange plans.