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Accident-and-Health-or-Sickness-Producer Practice Test Training Materials - Accident-and-Health-or-Sickness-Producer Test Prep - RealVCE

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Maryland Insurance Administration MarylandAccident and Health or Sickness Producer Series 20-24 Exam Sample Questions (Q28-Q33):

NEW QUESTION # 28
Which statement is true of trade association groups eligible for group medical benefits?

A. Members of the association are usually in the same industry
B. The association membership primarily consists of large employers
C. Employer contributions are usually waived
D. Such associations are formed for the purpose of purchasing insurance

Answer: A

Explanation:
Trade associations (Insurance Article, § 15-1209) group members in the same industry for medical benefits, not solely for insurance, and include small employers with contributions typically required.
References:Maryland Insurance Article, § 15-1209; MIA group insurance rules.

NEW QUESTION # 29
Reasonable and customary charges for health care are based primarily on:

A. Actuarial tables
B. Average charges within a geographic area
C. National physician surveys
D. Insurance industry studies

Answer: B

Explanation:
Reasonable and customary charges (Insurance Article, § 15-1005) reflect average fees for procedures in a specific geographic area (e.g., 80th percentile), ensuring fair reimbursement. Actuarial tables, studies, and national surveys aren't the primary basis.
References:Maryland Insurance Article, § 15-1005; MIA health insurance guidelines.

NEW QUESTION # 30
Accident and health policies must cover physically or mentally handicapped dependent children:

A. To age 19
B. For life
C. To age 25
D. Until they become self-sustaining

Answer: B

Explanation:
Maryland law (Insurance Article, § 15-401) requires coverage for handicapped dependent children beyond standard age limits if they're incapable of self-sustaining employment and dependent on the insured. This extends for life, or as long as the policy is active, not limited to ages 19 or 25, nor tied to self-sustainability.
References:Maryland Insurance Article, § 15-401; MIA dependent coverage regulations.

NEW QUESTION # 31
Which benefit is usually excluded from accident and health plan coverage?

A. Hospital expense
B. Surgical expense
C. Custodial care
D. Physicians' visits

Answer: C

Explanation:
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.

NEW QUESTION # 32
Coverage for the first three pints of blood for Medicare enrollees is:

A. A Medicare Part B benefit
B. A Medicare Part A benefit
C. A Medicare Supplement additional benefit
D. A Medicare Supplement core benefit

Answer: D

Explanation:
Medicare Part A excludes the first three pints of blood for inpatient care, but Medigap core benefits (Insurance Article, § 15-901) cover this cost across all plans (A-J), making it a standard, not additional, benefit. Parts A and B don't include it directly.
References:Maryland Insurance Article, § 15-901; CMS Medicare guidelines.

NEW QUESTION # 33
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