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Maryland Insurance Administration MarylandAccident and Health or Sickness Producer Series 20-24 Exam Sample Questions (Q71-Q76):

NEW QUESTION # 71
Group health insurance contracts providing coverage for employees in more than one state are usually controlled by the laws of the state where:

• A. The master contract is issued
• B. The majority of employees reside
• C. The producer resides
• D. The application is signed

Answer: A

Explanation:
Multi-state group plans (Insurance Article, § 15-1202) are governed by the state where the master contract is issued, typically the employer's home state, ensuring consistent legal oversight regardless of employee location or producer residence.
References:Maryland Insurance Article, § 15-1202; MIA multi-state group rules.

NEW QUESTION # 72
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

Answer: C

Explanation:
HMOs (Health-General Article, § 19-701) ensure 24/7 access to hospital, emergency, and primary care services. Dental care isn't a core requirement and isn't typically available 24/7 unless added separately.
References:Maryland Health-General Article, § 19-701; MIA HMO standards.

NEW QUESTION # 73
When a single major medical contract covers all medical expenses, the plan is considered to be:

• A. First-dollar
• B. Limited
• C. Comprehensive
• D. Supplemental

Answer: C

Explanation:
A single policy covering all medical expenses (Insurance Article, § 15-201) is comprehensive, unlike limited (specific), first-dollar (no deductible), or supplemental (add-on) plans.
References:Maryland Insurance Article, § 15-201; MIA major medical standards.

NEW QUESTION # 74
Medical charges that fall within the range of fees normally charged for a given procedure in a certain geographical area are called:

• A. Preapproved charges
• B. Scheduled charges
• C. Utilization charges
• D. Reasonable and customary charges

Answer: D

Explanation:
Reasonable and customary charges are the typical fees for a procedure in a geographic area, used to set reimbursement levels (Insurance Article, § 15-1005). Preapproved charges require prior authorization, utilization charges relate to service reviews, and scheduled charges are fixed fees, none of which define this standard.
References:Maryland Insurance Article, § 15-1005; MIA health insurance guidelines.

NEW QUESTION # 75
An insurance adviser's written contract with the client must include all of the following EXCEPT:

• A. Expiration date of the consultant's license
• B. Duration of the contract
• C. Disclosure as to whether commissions may be received
• D. Amount of the fee

Answer: A

Explanation:
Adviser contracts (Insurance Article, § 10-201) require fee amounts, contract duration, and commission disclosure for transparency. The consultant's license expiration is a regulatory detail, not a client contract requirement.
References:Maryland Insurance Article, § 10-201; MIA adviser rules.

NEW QUESTION # 76
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