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Maryland Insurance Administration MarylandAccident and Health or Sickness Producer Series 20-24 Exam Sample Questions (Q83-Q88):
NEW QUESTION # 83
When an accident and health insurer requires a covered individual to undergo a physical examination, who pays the cost of the examination?
Answer: A
Explanation:
If an insurer mandates a physical exam (Insurance Article, § 12-202), it pays the cost, as it's a condition of coverage or claims processing. The premium payor, insured, or patient isn't responsible for insurer-initiated requirements.
References:Maryland Insurance Article, § 12-202; MIA policy standards.
NEW QUESTION # 84
In HMO coverage, all of the following services must be available 24 hours per day, 7 days per week EXCEPT:
Answer: A
Explanation:
HMOs (Health-General Article, § 19-701) ensure 24/7 access to hospital, emergency, and primary care services. Dental care isn't a core requirement and isn't typically available 24/7 unless added separately.
References:Maryland Health-General Article, § 19-701; MIA HMO standards.
NEW QUESTION # 85
Which benefit is usually excluded from major medical expense plan coverage?
Answer: D
Explanation:
Major medical plans (Insurance Article, § 15-201) cover hospice, drugs, and therapy, but excluderoutine dental care, which requires separate dental insurance.
References:Maryland Insurance Article, § 15-201; MIA major medical standards.
NEW QUESTION # 86
Medicare Supplement insurance is specifically designed for individuals who:
Answer: C
Explanation:
Medicare Supplement (Medigap, Insurance Article, § 15-901) is for Medicare enrollees (Parts A and B) to cover gaps, not low-income (Medicaid), uninsurable (pre-ACA pools), or employer-ineligible individuals.
References:Maryland Insurance Article, § 15-901; MIA Medigap rules.
NEW QUESTION # 87
In Maryland, a group accident and health certificate of insurance must contain:
Answer: D
Explanation:
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.
NEW QUESTION # 88
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