Maryland Life and Health Law Exam Simulator
According to the Affordable Care Act, new Health Insurance Marketplaces are established by the
CCIIO (The Center for Consumer Information and Insurance Oversight)
Which of the following is NOT considered to be an act of fraud?
Collecting a charge for insurance that is less than the charge applicable to that insurance
Before a Medicare Supplement advertisement is released to the public, it must first be approved by the
Commissioner
Which renewal provision must ALL Medicare Supplement policies contain?
Guaranteed renewable
Which of the following is NOT required in an order from the Commissioner?
The Governor's signature
An insurance producer is BEST defined as
a person who has a contract with an insurance company to represent it
Which of the following life events would allow an uninsured employee to qualify for special enrollment in a small employer health benefit plan?
adoption of a child
If replacement was involved in the sale of an insurance policy, a producer must provide a replacement notice no later than the
application date
All of these are considered to be a violation of the Federal Fraud and False Statements Act EXCEPT
claims reimbursement
All of the following are typically included in a life insurance policy illustration EXCEPT
names of the beneficiaries
The _____ is responsible for determining the appropriateness of a Medicare Supplement policy for an applicant.
producer
All of these activities require an individual to hold a producer's license EXCEPT
providing referrals
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
the daily amount paid for nursing home care
What does "SHOP" stand for in SHOP Exchange?
Small Business Health Options Program
A producer has committed an insurance crime that violates US Code 1033 (interstate commerce). Who would be responsible for the prosecution of this crime?
US Attorney General
Advertising regulations exist to
assure full and truthful disclosures to the public
Twisting means
persuading an insured, to the insured's detriment, to switch policies
Whose interests are being protected under replacement rules?
policyowner
An example of misrepresentation is
providing incorrect, misleading, incomplete, or materially untrue information in the license application
At minimum, a carrier is required to offer which of the following health benefit plans to small employers?
the standard plan
Security laws passed by Congress are enforced by which Federal agency?
Security and Exchange Commission
To be classified as a small employer in Maryland, an employer must employ
2-50 employees
A licensee who is required to take continuing education must complete 24 hours of continuing education, which includes ___ hour(s) of ethics coursework
3
how many days notice does the affordable care act require insurers to give before rescinding coverage
30
Newborn children are automatically covered under an existing family medical plan at the moment of birth for a period of at least ___ days
31
Which license is REQUIRED in order to solicit Long Term Care insurance in the State of Maryland?
Health Insurance Producer License
The Commissioner must examine the financial affairs of each admitted insurer operating in Maryland at least once every how many years?
5
The financial records of each domestic company MUST be inspected every ___ years by the Commissioner
5
A Medicare Supplement policy may exclude coverage for a preexisting condition for up to ___ months
6
A pre-existing conditions limitation may NOT exceed ___ month(s) in all Medicare Supplement policies sold in Maryland.
6
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.
60
Proof of loss on a health insurance claim must be submitted to an insurer within ___ days after the insured's date of loss.
90
A life insurance policyowner is allowed ___ days upon policy delivery to return the policy for a full premium refund.
10
How many days notice must the Commissioner give prior to a hearing?
10 days
Written notice of a health insurance claim should be given within ___ days after the occurrence of any loss covered by the policy.
20
Tim's individual life insurance policy has just recently lapsed. His policy may be reinstated at any time within ___ year(s)
3 (Lapsed life insurance policies can be reinstated at any time within three years from the date of premium default)
A licensee MUST notify the Commissioner of an address change within ___ days of the change
30
Which type of contract may NOT be issued by an insurance company?
HMO contract
A producer's renewal date for his/her resident insurance license is on or before
the last day of the licensee's birth month
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
Commissioner
Who is required to notify the producer in the event of appointment termination?
Insurer
In regards to technology and the ACA, which of the following statements is correct?
States which operate with an Exchange must offer an internet-based portal
A domestic insurance company in Maryland MUST
be formed under Maryland insurance laws
All Medicare supplement policies sold during the open enrollment period MUST
be issued regardless of health status
Actuarial Value Plans
bronze = 60% silver = 70% gold = 80% platinum = 90%
An example of replacement is
cancelling a term life policy to buy a whole life policy
Which of these is NOT considered a Federal punishment for unfair and deceptive insurance practices?
community service (punishment for unfair and deceptive insurance practice may include a fine, imprisonment and license revocation but not community service)
In regards to the Affordable Care Act (ACA), which of these is NOT a role of a health insurance exchange?
contact the employer if an employee stops coverage under a plan offered in the exchange
The Maryland Insurance Commissioner
counsels and advises the Governor on all matters assigned to the Maryland Insurance Administration
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
creditors
Which of these is NOT an Unfair Claims Settlement Practice?
denying unsubstantiated claims on a timely basis
A producer must maintain customer records for ___ year(s) following the completion date of the insurance transaction.
five
a dependent child may remain on a parent's health insurance plan beyond age 26 if the child
has a mental or physical handicap and remains dependent on the parent
An existing health benefit plan offered by a small employer may be replaced by a SHOP Exchange Navigator only if the small employer
is eligible for a Federal tax credit through the SHOP Exchange
According to the Affordable Care Act (ACA), the proportion of premium revenues spent on clinical services and quality improvements is called the
medical loss ratio
all long-term care policies sold in maryland MUST contain a(n)
nonforfeiture clause
If a Medicare Supplement policy is cancelled by the insurer, which of these circumstances does NOT require prior approval by the Commissioner
nonpayment of premium
Under which circumstance would inflation protection NOT be included in a long-term policy?
policyowner declines the coverage in writing
Replacement regulation is designed to protect
policyowners from misrepresentation and loss of benefits
A producer has indicated to a potential client that the proposed life insurance policy is covered by the Maryland Life and Health Insurance Guaranty Association. This action taken by the producer is
prohibited by law
the commissioner is empowered to perform each of the following acts EXCEPT
prosecute producers who violate state insurance laws
Which of these is NOT an Unfair Claims Settlement Practice?
providing claim payments to insureds under the guidelines of the insurance contract
An insurance producer agrees to pay the first monthly premium for an insurance applicant. This is called a(n)
rebate
Once a child is born and covered under a health insurance plan, any reduction in benefits on the newborn is
strictly prohibited
how many days notice must a producer be given prior to a scheduled hearing?
10 days
_____ is the authority given to a producer to sell, solicit, or negotiate insurance on behalf of the insurer
Appointment
Beginning January 1, 2014, the restricted annual limit for plans under the Affordable Care Act will be
No Limit
What is the required action to be taken by a Maryland licensee before operating under an assumed business name?
Notify Commissioner
What is considered interstate travel under the Federal Fraud and False Statements Act?
Puerto Rico
Insurance agent Kelly offers insured a $500 shopping card if they purchase an insurance product through her. Which is this an example of?
Rebating
An insurance producer who replaces an existing policy by making false written or oral statements is committing the act of
twisting
Starting in 2016, businesses with up to ___ employees will be defined by the ACA as a "small business".
100
What is the MINIMUM benefit period that must be offered by a Long-Term Care policy?
12 months
A temporary producer license issued in Maryland is valid for up to
15 months
Once a health insurance policy has been in force for ___ year(s), the policy may NOT be contested by the insurer
2
A life insurance policy sold in Maryland can be cancelled for nonfraudulent misstatements for up to
2 years
How long after its effective date will an individual life insurance policy become incontestable?
2 years
How long is the Contestable Period for health insurance policies sold in Maryland?
2 years
A life insurance replacement gives the policyowner the right to return the policy for a 100% refund within ___ days of policy delivery
30
Any administrative action taken against a producer MUST be reported to the Commissioner within ___ days after the final disposition
30
The Right-to-Examine period in Maryland for Long-Term Care policies is ___ days
30
Within how many days must a producer report to the Commissioner any administrative actions made against him/her?
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.
30 days
The standard grace period for a life insurance policy sold in maryland is
30 days
Greg had recently been terminated from his job that covered him for group life insurance. How long does he have to convert his coverage to an individual policy?
31 days
A Long-Term Care policy may ONLY exclude pre-existing conditions for up to ___ months
6
Which of the following unfair trade practices involves a producer who makes public malicious statements about an insurer's financial condition?
defamation
A separate converted policy may, at the option of the insurance company, be issued to cover a(n)
dependent
All of these types of benefits may be covered by a nonprofit health service plan EXCEPT
disability income
Group life plans sold in Maryland typically contain a conversion option. If the insured elects this option, the new policy
does NOT require evidence of insurability
all of these are responsibilities of the Commissioner EXCEPT
endorsing insurers
The "Notice to Buyer" on the first page of each long-term care policy delivered in Maryland
explains that some long-term care costs may not be covered
A minor may receive a life insurance policy's death benefit ONLY
if the minor has an appointed guardian
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
illegal inducement
An insurer is REQUIRED to offer which of the following to each long-term care applicant at the time of purchase?
inflation protection
Under the Maryland Health Insurance Plan, comprehensive health benefits are provided to
medically uninsurable residents
the life and health guaranty corporation provide funds to carry out its powers and duties by assessing
member insurers
A producer may be disciplined by the Commissioner for which of the following actions?
misappropriation of premium funds
Jose recently had his long-term care policy replaced with a new policy. The new long-term care policy may NOT impose a(n)
new pre-existing conditions exclusion
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
remain in effect until a new one is issued
Which of the following is NOT a prohibited sales practice for marketing long-term care coverage?
replacing existing coverage with a new policy
Which of these situations would NOT potentially involve a prison sentence under Federal law?
selling insurance with a nonresident license
The outline of coverage for a Medicare Supplement policy provides information about
services, benefits, copayments, deductibles, exclusions, premiums, and the insurer
Chuck and Shaquille are both licensed producers in the same line of insurance. Chuck provides Shaquille with a referral that results in a sale. Commissions on this sale will likely be
shared by both producers (sharing of commission is allowed between producers licensed in the same line of insurance)
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
she may need to resume premium payments, depending on actual results
An individual life insurance policy can be contested by the insurer only during the first ___ year(s) of the contract
two
According to federal fraud and false statements regulation, what is required for a prohibited person to transact insurance business in this state
written consent from the state insurance regulatory agency
