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Maryland Insurance Administration MarylandAccident and Health or Sickness Producer Series 20-24 Sample Questions:

1. All of the following are typical health maintenance organization (HMO) preventive care services provided by a primary care physician EXCEPT:

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

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

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

3. All of the following are examples of unfair claims settlement practices EXCEPT:

A) Denying unsubstantiated claims on a timely basis
B) Misrepresenting pertinent facts of coverage
C) Failing to promptly provide a reason for a claim denial
D) Refusing arbitrarily and unreasonably to pay claims

4. Which of the following is NOT a mandated benefit in Maryland?

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

5. A certificate of insurance in a group accident and health plan is:

A) A binding contract between the employee and the insurer
B) Issued to the employer for each insured location
C) Evidence of the employee's insurance coverage
D) A binding contract between the employer and the insurer

Solutions: