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Accident-and-Health-or-Sickness-Producer Test Score Report | Accident-and-Health-or-Sickness-Producer Exam Answers

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Maryland Insurance Administration MarylandAccident and Health or Sickness Producer Series 20-24 Exam Sample Questions (Q74-Q79):

NEW QUESTION # 74
Which of the following is a requirement of an insurable risk?

• A. The loss must be catastrophic.
• B. The chance of loss must be calculable.
• C. The loss must be intentional.
• D. There must be a large number of different loss exposures.

Answer: B

Explanation:
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.
References:Maryland Insurance Principles, Actuarial Standards, and COMAR 31.09.14.

 

NEW QUESTION # 75
Medical charges that fall within the range of fees normally charged for a given procedure in a certain geographical area are called:

• A. Reasonable and customary charges
• B. Preapproved charges
• C. Scheduled charges
• D. Utilization charges

Answer: A

Explanation:
Reasonable and customary charges are the typical fees for a procedure in a geographic area, used to set reimbursement levels (Insurance Article, § 15-1005). Preapproved charges require prior authorization, utilization charges relate to service reviews, and scheduled charges are fixed fees, none of which define this standard.
References:Maryland Insurance Article, § 15-1005; MIA health insurance guidelines.

 

NEW QUESTION # 76
If an employer with 200 employees wants to offer health insurance and calls a SHOP Exchange Navigator, what should the navigator do?

• A. Refer the employer to the carrier where a friend works
• B. Refer the employer to the Maryland Insurance Administration
• C. Refer the employer to a licensed insurance producer
• D. Help the employer sign-up through the SHOP Exchange

Answer: C

Explanation:
SHOP Exchange (Insurance Article, § 31-101) serves employers with 1-50 employees; a 200-employee firm exceeds this, so the navigator should refer them to a producer for large group plans, not assist via SHOP, refer personally, or send to the MIA.
References:Maryland Insurance Article, § 31-101; MIA SHOP Exchange guidelines.

 

NEW QUESTION # 77
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. Replacement
• C. Rebating
• D. Twisting

Answer: A

Explanation:
Producers hold premiums in a fiduciary capacity (Insurance Article, § 10-126) and must remit them to the insurer or a trust account. Depositing them into a personal account is fraud-specifically misappropriation- violating state law. Twisting, rebating, and replacement involve different unethical acts, not fund misuse.
References:Maryland Insurance Article, § 10-126; MIA producer conduct regulations.

 

NEW QUESTION # 78
Which of the following is NOT a mandated benefit in Maryland?

• A. Weight reduction programs
• B. Treatment of substance abuse
• C. Hearing aids for children
• D. Treatment of mental illness

Answer: A

Explanation:
Maryland mandates mental health (§ 15-802), substance abuse (§ 15-803), and hearing aids for children (§ 15-
838), but weight reduction programs are elective and not required (Insurance Article, § 15-801).
References:Maryland Insurance Article, § 15-801, § 15-802, § 15-803, § 15-838; MIA mandated benefits.

 

NEW QUESTION # 79
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