ACCIDENT-AND-HEALTH-OR-SICKNESS-PRODUCER EXAM PRACTICE - EXAM ACCIDENT-AND-HEALTH-OR-SICKNESS-PRODUCER TIPS

Accident-and-Health-or-Sickness-Producer Exam Practice - Exam Accident-and-Health-or-Sickness-Producer Tips

Accident-and-Health-or-Sickness-Producer Exam Practice - Exam Accident-and-Health-or-Sickness-Producer Tips

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Maryland Insurance Administration MarylandAccident and Health or Sickness Producer Series 20-24 Exam Sample Questions (Q42-Q47):

NEW QUESTION # 42
When the employer pays the premium, covered individuals normally receive tax-free benefits under all of the following group health plans EXCEPT:

  • A. Major medical
  • B. Disability income
  • C. Dental
  • D. Health maintenance organization

Answer: B

Explanation:
Federal tax rules (IRC § 105, § 106) make employer-paid medical benefits (major medical, dental, HMO) tax- free, but disability income benefits are taxable if employer-funded, as they replace income.
References:IRC § 105, § 106; Maryland Insurance Article, § 15-1201; MIA tax guidelines.


NEW QUESTION # 43
A health maintenance organization (HMO) must provide coverage for all of the following EXCEPT:

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

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 # 44
In HMO coverage, all of the following services must be available 24 hours per day, 7 days per week EXCEPT:

  • A. Primary care
  • B. Dental care
  • C. Emergency medical care
  • D. In-patient hospital services

Answer: B

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 # 45
If an individual's occupation is considered to be illegal:

  • A. It must be stated as such on an accident and health insurance application
  • B. It results in a substandard rating on an accident and health insurance policy
  • C. It may result in a denial of a disability income claim
  • D. It may require a waiver on a disability income insurance policy

Answer: C

Explanation:
Illegal occupations (Insurance Article, § 12-101) can lead to claim denials if disability arises from illegal acts, per public policy. Disclosure isn't mandated, waivers don't apply, and ratings adjust risk, not legality.
References:Maryland Insurance Article, § 12-101; MIA claims policies.


NEW QUESTION # 46
All of the following are typical health maintenance organization (HMO) preventive care services provided by a primary care physician EXCEPT:

  • A. Well-baby checkups
  • B. Immunizations for children
  • C. Experimental surgery
  • D. Physical examinations

Answer: C

Explanation:
HMOs (Health-General Article, § 19-701) provide preventive care like checkups, immunizations, and exams.
Experimental surgery isn't preventive or standard, making it the exception to covered services.
References:Maryland Health-General Article, § 19-701; MIA HMO guidelines.


NEW QUESTION # 47
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