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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