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licensed producers not appointed by an insurer

Producer commissions may NOT be paid to

3

Maryland requires that a licensee completes ______ hours of continuing education on the subject of ethics every reporting period

Care is covered

Maria is a Preferred Provider Organization (PPO) subscriber and received care from an out-of-network provider. Which of the following is the likely result?

MEWA (Multiple Employer Welfare Arrangement)

Small employers who are sponsored by an insurer to provide group benefits to its employees are called

5

The Commissioner must examine the financial affairs of each admitted insurer operating in Maryland at least once every how many years?

30 days

The standard grace period for a life insurance policy sold in Maryland is

25

To be eligible for small employer group coverage, an employee must work a MINIMUM of ____ hours in a typical week.

medically uninsurable residents

Under the Maryland Health Insurance Plan, comprehensive health benefits are provided to

issue a cease and desist order

Upon receiving a producer complaint, the Commissioner may immediatley

Submit to the replacing insurer a list of the policies to be replaced

Which of the following actions is REQUIRED by a producer who is replacing an existing life insurance policy?

Collecting premiums and paying them to the insurance company

Which of the following basics is a producer's fiduciary responsibility?

Medical Insurance

Which of the following is Medicare Part B also known as?

Prospective producer who is waiting to take the state examination

Which of the following is NOT a circumstance to which a temporary producer license can be issued?

High School diploma

Which of the following is NOT a qualification to be licensed as a producer?

Unintentionally misrepresented a material fact on the application

Which of the following is NOT a reason for the Commissioner to deny or refuse a producer license application?

How to take legal action against an insurance company

Which of the following is NOT information found in a life insurance buyer's guide?

Certificate of authority

Which of the following is required for an insurer to conduct business in this state?

HMO contract

Which type of contract may NOT be issued by an insurance company?

Insurer

Who is required to notify the producer in the event of appointment termination?

30

Within how many days must a producer report to the Commissioner any administrative actions made against him/her?

20

Written notice of a health insurance claim should be given to the insurer within _____ days after the occurrence of any loss covered by the policy

Appointment

_______________ is the authority given to a producer to sell, solicit, or negotiate insurance on behalf of the insurer

have it's content approved by the commissioner

A Buyer's Guide MUST

must be delivered with or prior to policy delivery

A Buyer's Guide and Policy Summary

company

A Maryland insurance producer solicits an insurance policy. In the event of a controversy between the insured and the company, the producer is considered to represent the

100% of the billed amount

A closed network plan offers a primary physician copay of $25. If a subscriber chooses a primary care physician outside of the network, the subscriber will likely pay

be formed under Maryland insurance laws

A domestic insurance company in Maryland MUST

Dental treatment is needed to repair an injury

A hospital or medical expense policy will typically cover dental treatment expenses under which circumstance?

8%

A life policy loan in Maryland cannot charge a fixed rate of interest higher than

10

A policyowner has _____ days after policy delivery to return a major medical policy for a full refund

5

A producer MUST maintain insurance transaction records for a minimum of ____ years

US Attorney General

A producer has committed an insurance crime that violates US Code 1033 (interstate commerce). who would be responsible for the prosecution of this crime?

Financial objectives

A producer is meeting with a client to determine whether an annuity would be suitable for purchase. Which of the following topics needs to be discussed with this client?

Misappropriation of premium funds

A producer may be disciplined by the Commissioner for which of the following actions?

appointed by an insurer

A producer may begin to solicit insurance ONLY when

30

A producer must notify the Commissioner within _____ days of a felony conviction

nonresident producer

A producer who is licensed in Maryland but resident in another state is called a

Dependent

A separate converted policy may, at the option of the insurance company, be issued to cover a

User premiums

Funding for Medicare Part B is partially provided by

Child over the age of 18 years who attends an educational institution and relies on the insured employee for financial support

ABC Corporation has a group life insurance policy that covers its employees and their dependent children. Which of the following would be considered a "dependent child"?

the daily amount paid for nursing home care

All long-term care policies sold in North Dakota are REQUIRED to pay the SAME daily benefit amount for "at home" care as paid for

sharing commissions with other licensed and appointed agents

All of the following actions are considered rebating EXCEPT

Providing referrals

All of these activities require an individual to hold a producer's license EXCEPT

Endorsing insurers

All of these are responsibilities of the Commissioner EXCEPT

coinsurance

An indemnity plan limitation that will pay the dental bills after a small amount is paid by the insured is called

When becoming eligible for Medicare

An individual can enroll in a Part C Medicare Advantage Plan at what time?

Subscriber

An individual covered under a Blue Cross Blue Shield plan is called a

rebate

An insurance producer agrees to pay the first monthly premium for an insurance applicant. This is called a

A person who has a contract with an insurance company to represent it

An insurance producer is BEST defined as

Tobacco use

As of January 1, 2014, small group health insurance can be rated on the basis of

65

At what age does the open enrollment period typically begin for Medicare Supplement coverage?

Must not duplicate Medicare benefits

Benefits for a Medicare Supplement policy

Senile dementia

Claims for a Long-Term Care policy MUST be paid for which of the following conditions?

26

Dependent children under a health insurance plan must be provided coverage up to age

3 years

How long must a life insurance policy be in effect before the policyowner may use the nonforfeiture provision?

Material misrepresentation

A Medicare Supplement policy may be cancelled by an insurer for which of the following reasons?

6

A Medicare Supplement policy may exclude coverage for a preexisting condition for up to ____ months

foreign

A ______ insurance company is one that was formed under the laws of a state other than Maryland

stock

A _______ company is owned by its shareholders

producer

A _______ negotiates an insurance contract on behalf of an insurer

has a mental or physical handicap and remains dependent on the parent

A dependent child may remain on a parent's health insurance plan beyond age 26 if the child

30

A licensee MUST notify the Commissioner of an address change within _______ days of the change

2

A life insurance policy sold in Maryland can be cancelled for nonfraudulent misstatements for up to

10

A life insurance policyowner is allowed ____ days upon policy delivery to return the policy for a full premium refund

is the minor has an appointed guardian

A minor may receive a life insurance policy's death benefit ONLY

31

A newborn is required to be covered for ______ days from the moment of birth.

2

A producer's license MUST be renewed every _______ years

has been afforded a right to a hearing

A producer's license may only be suspended or revoked if the producer

must be licensed as a producer

A producer's secretary who solicits prospects on the telephone

dependent

A separate converted policy may, at the option of the insurance company, be issued to cover an

make any transactions before being approved for a licence

A viatical settlement broker may NOT

alien

An ___________ insurance company is one that was formed under the laws of another country outside of the U.S.

insured

An accident and health policy that provides reimbursement benefits makes them payable to the

the insurer's name

An advertisement for an insurance product may contain

providing incorrect, misleading, incomplete, or materially untrue information in the license application

An example of misrepresentation is

To a licensed producer who is appointed with the insurer

An insurer may pay a commission in which of the following scenarios?

The exceptions, reductions, and limitations affecting the basic provisions of the policy

Any advertisement that mentions a dollar amount, period of time for which any benefit is payable, cost of policy, policy benefit, or the loss for which the benefit is payable MUST disclose

The standard plan

At minimum, a carrier is required to offer which of the following health benefit plans to small employers?

licensed and duly appointed producers

Commissions may ONLY be paid to

birth abnormalities

Coverage for newborns under a health plan MUST include coverage for

must not impede the examination

During the examination of an insurer's books and records by the Commissioner, the insurer

unfair claim settlement practice

Failing to promptly provide a reasonable explanation for the denial of a claim is considered to be a

10 days

How many days notice must the Commissioner give prior to a hearing?

Every two years

How often must an insurance producer's license in Maryland be renewed?

Every five years

How often must the Commissioner examine each domestic insurance company?

30 hours

In Maryland, a full-time employee of a small employer MUST work an average of at least _____ per week

appointment

In Maryland, an insurance producer cannot sell, solicit, or negotiate policies for an insurer unless there is an agreement in place between the producer and insurer. This agreement is called an

represents the insurer

In the state of Maryland, a licensed producer

Rebating

Insurance producer Kelly offers an insured a $500 shopping card if an insurance product is purchased through her. What is this an example of?

30

Interest on death benefits are NOT required to be paid by an insurance company as long as proceeds are paid within ______ after the date of the death of the insured

one or more diagnostic, preventive, therapeutic, rehabilitative, maintenance, or personal care services in a setting other than an acute care unit of a hospital

Long-term care insurance provides

substance addictions

Long-term care policies sold in Maryland may exclude coverage related to

poverty stricken people

Medicaid is intended for

100 Days

Medicare Part A does not pay for medical benefits provided for treatment in a skilled nursing facility

written authorization from the proposed insured

Prior to conducting an HIV-related test, the insurer must obtain

enforce state insurance laws

One role of the Commissioner is to

occupational disease

Paul is an employee who caught a disease unique to the trade in which he was exposed to. Paul has an

24

Producers must complete a total of _______ Continuing Education hours for each two-year licensing period

90

Proof of loss on a health insurance claim must be submitted to an insurer within _____ days after the insure's date of loss.

Policyowners from misrepresentations and loss of benefits

Replacement regulation is designed to protect

viatical settlement

Terminally-ill life insurance policyowners may sell their policy at a discount to a third party. This type of agreement is called a

prepaid

The Federal Employees Benefit Program consists of two types of health plans for federal civilian employees. The two plans are fee-for-service and

off-label

The Food and Drug Administration approves prescription drugs for treatment as stated on the drug's labeling. The prescription of a drug for treatments other than what's labeled is known as _____ use

member insurers

The Life and health Guaranty Corporation provides funds to carry out its powers and duties by assessing

counsels and advises the Governor on all matters assigned to the Maryland Insurance Administration

The Maryland Insurance Commissioner

30

The Right-to-Examine period in Maryland for Long-Term Care policies is ____ days.

employer

The ________ has the right to renew a small employer health plan.

employer

The ___________ has the right to renew a small employer health plan

rebating

The promise of a discount in premium as an inducement to purchase insurance is known as

Commissioner

To conduct insurance business in this State, an insurer must be issued a certificate of authority. The entity which issues the certificate of authority is the

fine and/or imprisonment

Violations of US Code Title 18 section 1033 may result in

Bronze, Silver, Gold, and Platinum

What are the levels of coverage as defined by the Affordable Care Act?

Supplementary medical insurance

What is Medicare Part B also known as?

Notify Commissioner

What is the required action to be taken by a Maryland licensee before operating under an assumed business name?

obtain the beneficiary's signature

When a producer is replacing an existing ordinary life insurance policy, the producer must take all of the following actions EXCEPT

policy must be issued to XYZ, and a certificate must be issued to each employee

XYZ Corp was issued a group health policy for its employees. Under this plan a

reinsurance

ABC Insurance Company transfers part of their risk to XYZ Insurance Company. This situation is called

assure full and truthful disclosures to the public

Advertising regulations exist to

Names of the beneficiaries

All of the following are typically included in a life insurance policy illustration EXCEPT

An insurer's AM Best rating

All of the following is considered a form of advertising EXCEPT

group HMO

An HMO that involves a partnership of physicians and other providers who practice out of a central facility is called a

replacing an insurance policy from one insurer to another based on misrepresentation

Twisting is

Promptly

When must a claim on a life insurance policy be paid after proof of loss has been received by the insurer?

Health Insurance Producer License

Which license is REQUIRED in order to solicit Long Term Care insurance in the State of Maryland?

at least 21 years old

Which of the following is NOT a requirement for soliciting insurance in Maryland?

The Governor's signature

Which of the following is NOT required in an order from the Commissioner?

A producer who knowingly submits a false statement in support of a claim

Which of the following is an example of fraud?

Adoption of a child (an uninsured, eligible employee who acquires a new dependent through marriage, birth, or adoption may qualify for special enrollment in a small employer's health benefit plan)

Which of the following life events would allow an uninsured employee to qualify for special enrollment in a small employer health benefit plan?

Providing claim payments to insureds under the guidelines of the insurance contract

Which of these is NOT an Unfair Claims Settlement Practice?

Gatekeeper

Which of these will typically authorize treatment from a specialist?

Every member of that union

Who is eligible for insurance under a group policy issued to a labor union?

Defamation

Which of the following unfair trade practices involves a producer who makes public malicious statements about an insurer's financial condition?

Secretary of the Department of Health and Mental Hygiene

Who regulates the quality care provided by a health maintenance organization (HMO)?

6

A Long-Term Care policy may only exclude pre-existing conditions for up to _____ months

nonpayment

A Medicare Supplement policy can be cancelled by the insurer for

30

A life insurance replacement gives the policyowner the right to return the policy for a 100% refund within _____ days of policy delivery

an advisor

A person who, for a fee, gives advice or recommendations on benefits provided by an insurance contract is called

the Guaranty Association

A producer does NOT have a fiduciary responsibility to

temporary insurance license

A producer has recently died and leaves behind a spouse. In order for the producer's insurance business to continue, the Commissioner may issue to the producer's spouse a

Policy Summary and Buyer's Guide

A producer who sells an individual life insurance policy in Maryland MUST deliver to the policyowner a

illegal inducement

ABC Insurance Agency is entering each applicant who purchases insurance through their agency into a drawing to win a free trip. This is an unlawful practice known as

Pre-existing conditions may only be excluded from coverage for a maximum of 6 months

All Medicare Supplement policies MUST contain which provision?

Refusing to pay persons bringing false or fraudulent claims

All of these may be an Unfair Claims Practice EXCEPT

disability income

All of these types of benefits may be covered by a nonprofit health service plan EXCEPT

insurance producer

An ____ _____ sells, solicits, or negotiates insurance contracts for compensation

18

An eligible employee can be excluded from group health coverage for up to _______ months is he/she is considered a "late enrollee".

a producer who shares commissions with a client

An example of rebating is

cancelling a term life policy to buy a whole life policy

An example of replacement is

is eligible for a Federal tax credit through the SHOP Exchange

An existing health benefit plan offered by a small employer may be replaced by a SHOP Exchange Navigator only if the small employer

two

An individual life insurance policy can be contested by the insurer only during the first _________ years of the contract

misrepresentation

An insurance producer who convinces a prospective insured to purchase a policy by exaggerating the benefits of the policy may be found guilty of

twisting

An insurance producer who replaces an existing policy by making false written or oral statements is committing the act of

alien insurer

An insurer formed according to the legal requirements of another country is called an

legible and brief description of the policy on the first page

Each delivered life insurance policy in Maryland MUST include a

2

How long is the Contestable Period for health insurance policies sold in Maryland?

60

If an insurer refuses to pay a claim, how many days must the insured wait to take legal action against a health insurer after submitting written proof of loss?

Signing a prospect's name without their knowledge or presence

In Maryland, a Producer may have his/her license revoked for which of the following acts?

Creditors

Jim recently sold his whole life insurance policy under a viatical settlement contract. The proceeds of this contract could be subject to the claims of

remain in effect until a new one is issued

John the insurance producer has an insurance license that expires in 6 months. If he files an application for renewal before the expiration date, his license will

Fraud

Maria the insurance producer completes a sale by collecting the required signatures on the application and obtaining the initial premium. Afterwards, she deposits the check into her personal checking account. Maria has committed what crime?

2

Once a health insurance policy has been in force for _______ years, the policy may NOT be contested by the insurer

accelerated benefits

Proceeds payable under a life insurance contract to a policyowner in anticipation of death or upon the occurrence of specified life-threatening conditions as defined by the policy are best described as:

fiduciary

Recording the receipt and distribution of premiums due to an insurer is considered a producer's _________ responsibility

exchanging a new policy for one already in force

Replacement can be BEST described as

application

The Entire Contract provision states that an entire contract consists of the actual policy and the

with guidelines regarding credit reporting and distribution

The Fair Credit Reporting Act protects consumers

producer

The _______ is responsible for determining the appropriateness of a Medicare Supplement policy for an applicant

Outline

The _____________ of Coverage describes policy features, benefits, exclusions, and riders in a Long-Term Care policy

Commissioner

The ______________________ must be notified of a licensee's address change within 30 days of such change

first page

The renewability provision for an individual long-term care insurance policy must be located on the policy form's

Collecting a charge for insurance that is less than the charge applicable to that insurance

Which of the following is NOT considered to be an act of fraud?

2-50 employees

To be classified as a small employer in Maryland, and employer must employ

50

To be classified as a small employer, an employer must NOT have more than _________ eligible employees

misrepresentation

Twisting is an illegal act which involves

they are both licensed in the same line of business

Two producers may share a commission ONLY if

60

Under a small group health plan, an insurer is required to provide a newly-married employee at least ____ days to add the new spouse to the plan

12 Months

What is the MINIMUM benefit period that must be offered by a Long-Term Care Policy?

Producing an inadequate amount of new premium

Which of the following actions by a producer would NOT result in a license suspension or revocation?

the last day of the licensee's birth month (every two years)

A producer's renewal date for his/her resident insurance license is on or before

15

A temporary producer license in Maryland is valid for up to

Inflation protection

An insurer is REQUIRED to offer which of the following to each long-term care applicant at the time of purchase?

cease and desist order

An order issued by the commissioner that prohibits a specific practice listed in the order is called a

the exceptions, reductions, and limitations affecting the basic provisions of the policy

Any advertisement that mentions a dollar amount, period of time for which any benefit is payable, cost of policy, policy benefit, or the loss for which the benefit s is payable MUST disclose

she may need to resume premium payments, depending on actual results

Kiara filled out a life insurance application and was given a policy illustration that showed future premiums being paid out of non guaranteed values. This illustration MUST disclose that

30

Long-term care insurance and Medicare Supplement plans have a free-lock period of ______ days

0

Mary's Medicare Supplement policy had been in effect for 12 months. She recently replaced the policy with a new one that provides better coverage. The replacing policy may only impose a ____ month time exclusion for pre-existing conditions

twisting

The act of using misrepresentation to induce an insured person to terminate an existing policy and purchase a new policy is referred to as

3

Tim's individual life insurance policy has just recently lapsed. His policy may be reinstated at any time within _____ years.

long-term care

What kind of insurance provides coverage for one or more necessary or appropriate diagnostic, preventative, therapeutic, rehabilitative, maintenance, or personal care services in a setting other than an acute care unit of a hospital?

Surrender charge

What may be the result of replacing an existing life insurance policy with a new one?

2 years

How long after its effective date will an individual life insurance policy become incontestable?

30

If a producer has been engaged in an administrative action by any governmental agency, within how many days following the final deposition must the producer report the action to the Commissioner?

insurer

The identity of the ____ must be made clear in every health insurance advertisement

forward premiums to the insurer on a timely basis

When collecting insurance premiums from a client, a producer MUST

Immediately

When is an existing health insurance policy required to provide coverage for a newborn child


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