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Maryland Insurance Administration MarylandAccident and Health or Sickness Producer Series 20-24 Exam Sample Questions (Q64-Q69):

NEW QUESTION # 64
In accident and health insurance, a waiting period for pre-existing conditions means that:

A. Coverage for pre-existing conditions is permanently excluded by a new insurer
B. A period of time must elapse before pre-existing conditions are covered
C. Payment for expenses resulting from pre-existing conditions is held in escrow
D. Coverage for pre-existing conditions starts at the inception of the new policy

Answer: B

Explanation:
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.
References:Maryland Insurance Article, § 15-109; MIA pre-existing condition rules.

NEW QUESTION # 65
When determining the premiums for large groups, most insurance companies use:

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

Answer: B

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 # 66
Medical expense insurance typically EXCLUDES coverage for treatment of:

A. Undiagnosed diseases
B. Chronic back pain
C. Eating disorders
D. Intentionally self-inflicted injuries

Answer: D

Explanation:
Medical expense insurance covers necessary treatments like chronic pain, eating disorders (under parity laws,
§ 15-802), and undiagnosed conditions if treated, but excludes intentionally self-inflicted injuries (e.g., suicide attempts) as non-accidental losses (Insurance Article, § 15-201).
References:Maryland Insurance Article, § 15-201, § 15-802; MIA health insurance exclusions.

NEW QUESTION # 67
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. The accidental death of an HMO member
C. The dismemberment of an HMO member
D. Health care services provided to members of the HMO

Answer: D

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 # 68
An insured's statements on an accident and health insurance application are deemed to be:

A. General provisions
B. Warranties
C. Categorical
D. Representations

Answer: D

Explanation:
Statements on applications (Insurance Article, § 12-206) are representations-factual assertions to the best of the insured's knowledge-where only material misrepresentations void a policy. Warranties are stricter and less common, while categorical and general provisions don't apply.
References:Maryland Insurance Article, § 12-206; MIA application rules.

NEW QUESTION # 69
......

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