Accident-and-Health-or-Sickness-Producer Exam Dumps - Maryland Insurance Administration Maryland Insurance Questions and Answers

SHOP Exchange (Insurance Article, § 31-101) serves employers with 1-50 employees; a 200-employee firm exceeds this, so the navigator should refer them to a producer for large group plans, not assist via SHOP, refer personally, or send to the MIA.

References:Maryland Insurance Article, § 31-101; MIA SHOP Exchange guidelines.

Insurance (Insurance Article, § 1-101) transfers risk, shares losses, and protects against uncertainty, but it mitigates, not eliminates, risk, which remains inherent.

References:Maryland Insurance Article, § 1-101; MIA insurance basics.

Long-term care insurance (Insurance Article, § 18-101) triggers benefits based on inability to perform ADLs (e.g., bathing), unlike Medigap, major medical, or disability, which focus on medical or work criteria.

References:Maryland Insurance Article, § 18-101; MIA long-term care rules.

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.

Accident and health plans (Insurance Article, § 15-201) cover acute needs like hospital, physician, and surgical expenses. Custodial care—non-medical daily assistance—is excluded, typically covered by long-term care insurance.

References:Maryland Insurance Article, § 15-201; MIA health insurance standards.

Statements on applications (Insurance Article, § 12-206) are representations—factual assertions to the best of the insured’s knowledge—where only material misrepresentations void a policy. Warranties are stricter and less common, while categorical and general provisions don’t apply.

References:Maryland Insurance Article, § 12-206; MIA application rules.

A material misrepresentation (Insurance Article, § 12-206) allows the insurer to void the policy within the contestability period (typically 2 years) if willful. It’s not automatically void, nor must it continue or wait until renewal; the insurer decides based on materiality.

References:Maryland Insurance Article, § 12-206; MIA misrepresentation rules.