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Maryland Insurance Administration MarylandAccident and Health or Sickness Producer Series 20-24 Exam Sample Questions (Q85-Q90):

NEW QUESTION # 85
A health maintenance organization (HMO) must provide coverage for all of the following EXCEPT:

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

Answer: A

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 # 86
Short-term group disability income insurance:

A. Usually provides benefits expressed as a percentage of the insured's normal weekly wage, up to a specified weekly maximum
B. Usually coordinates the amount of benefits paid with disability benefits received under Social Security
C. Frequently provides coverage through age 65 for insureds who are over 55 when they become disabled
D. Often has a benefit period extending up to a maximum of ten years

Answer: A

Explanation:
Short-term disability (Insurance Article, § 15-201) pays a percentage of wages (e.g., 50-70%) up to a weekly cap for a short duration (e.g., 13-26 weeks). Coordination with Social Security, 10-year periods, or coverage to age 65 are long-term disability features.
References:Maryland Insurance Article, § 15-201; MIA disability insurance standards.

NEW QUESTION # 87
After completing an application for insurance, the insurance producer collects the premiums but deposits the check in the insurance producer's checking account. What crime has been committed?

A. Fraud
B. Rebating
C. Replacement
D. Twisting

Answer: A

NEW QUESTION # 88
When determining the premiums for large groups, most insurance companies use:

A. Occupational rating
B. Area rating
C. Experience rating
D. Pooled rating

Answer: C

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 # 89
Which type of coverage bases benefit eligibility on the capacity to perform activities of daily living?

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

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 # 90
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