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Accident-and-Health-or-Sickness-Producer認證考試問題與答案

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最新的 Maryland Insurance Accident-and-Health-or-Sickness-Producer 免費考試真題 (Q49-Q54):

問題 #49
A health maintenance organization (HMO) must provide coverage for all of the following EXCEPT:

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

答案：B

解題說明：
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.

 

問題 #50
In Maryland, a group accident and health certificate of insurance must contain:

• A. A copy of the group contract
• B. A list of all participating physicians
• C. A summary of policy features and benefits
• D. The insurer's financial statement

答案：C

解題說明：
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.
References:Maryland Insurance Article, § 15-1207; MIA group insurance rules.

 

問題 #51
To be deemed a "qualified employer" under the Maryland Health Benefit Exchange Act, anemployer MUST:

• A. Have its principal place of business in the state of Maryland
• B. Have at least 50% of its employees reside in the state of Maryland
• C. Contribute to employee premiums
• D. Have at least 50% of its employees work in the state of Maryland

答案：A

解題說明：
The Maryland Health Benefit Exchange Act (Insurance Article, § 31-101) defines a qualified employer as one with its principal place of business in Maryland for SHOP Exchange eligibility. Premium contributions are optional, and employee work or residency percentages aren't required.
References:Maryland Insurance Article, § 31-101; MIA SHOP Exchange rules.

 

問題 #52
When a producer sells an individual accident and health insurance policy, how is the initial premium usually paid?

• A. The insurer bills the applicant when the application is approved
• B. The producer collects and forwards it to the insurer
• C. The insurer utilizes the applicant's automatic bank draft authorization
• D. The applicant sends it directly to the insurer with the application

答案：B

解題說明：
Producers (Insurance Article, § 10-126) typically collect the initial premium with the application and forward it to the insurer, streamlining the process, unlike direct payment, billing, or bank drafts, which are less common initially.
References:Maryland Insurance Article, § 10-126; MIA producer procedures.

 

問題 #53
Which benefit is usually excluded from accident and health plan coverage?

• A. Custodial care
• B. Physicians' visits
• C. Surgical expense
• D. Hospital expense

答案：A

解題說明：
Accident and health plans (Insurance Article, § 15-201) cover acute needs like hospital, physician, and surgical expenses. Custodial care-non-medical daily assistance-is excluded, typically covered by long-term care insurance.
References:Maryland Insurance Article, § 15-201; MIA health insurance standards.

 

問題 #54
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