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Free Accident and Health or Sickness Producer Practice Questions

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Sample Practice Questions

Try these 10 sample questions from the Accident and Health or Sickness Producer practice bank. Each includes the answer and explanation. Continue with the interactive practice above to review the full question set.

  1. 1A Maryland resident applies for an individual Health producer license. What is the minimum age for eligibility?

    1. A. 18
    2. B. 19
    3. C. 21
    4. D. 25

    Answer: A

    Explanation: The controlling official text states "18 years old". Insurance Article §10-105 requires an individual applicant to be at least 18 years old.

    Reference: Article - Insurance — §10-105(b)(1)

  2. 2A health insurance analyst separates a covered event's cause from the insured's exposure and the resulting loss. What term describes the cause of an injury?

    1. A. Peril
    2. B. Hazard
    3. C. Risk
    4. D. Loss

    Answer: A

    Explanation: "Peril - the cause of property damage or personal injury" Peril names the cause; hazard changes likelihood or severity, risk is uncertainty, and loss is the result.

    Reference: NAIC Glossary of Insurance Terms — Glossary, Peril

  3. 3May a Maryland health insurer refuse to underwrite an applicant solely because of race?

    1. A. Yes, with actuarial data
    2. B. Race-based refusal is prohibited
    3. C. Yes, for individual policies
    4. D. Yes, after notice

    Answer: B

    Explanation: The controlling official text states "race, color, creed, sex, or blindness". Section 27-501 prohibits refusal, cancellation, or rate discrimination based on race and other protected traits.

    Reference: Article - Insurance — §27-501

  4. 4At delivery of an individual Maryland health policy, the producer promises a change in coverage. If the approval will be endorsed on or attached to the policy, whose approval is required to make the change valid?

    1. A. An executive officer of the insurer
    2. B. An appointed producer of the insurer
    3. C. A claims examiner of the insurer
    4. D. A benefits manager for the insured

    Answer: A

    Explanation: "No change in this policy shall be valid until approved by an executive officer of the insurer and unless such approval be endorsed hereon or attached hereto." An executive officer's approval is required in addition to endorsement or attachment; the other roles cannot supply that approval by position alone.

    Reference: Maryland Insurance Article §15-207 — §15–207, Entire contract; changes

  5. 5A self-employed client wants monthly payments to replace earnings if a disabling illness prevents work. Which type of health insurance addresses that income loss?

    1. A. Disability income insurance
    2. B. Major medical expense insurance
    3. C. Accidental death insurance
    4. D. Long-term care expense insurance

    Answer: A

    Explanation: "Disability Income - a policy designed to compensate insured individuals for a portion of the income they lose because of a disabling injury or illness." Disability income pays toward lost earnings; the other policies address care expenses or death from an accident.

    Reference: NAIC Glossary of Insurance Terms — Glossary, Disability Income

  6. 6A major medical plan requires 20% coinsurance. The insured has met the deductible, and the allowed amount for a covered service is $500 with no other cost-sharing adjustment. How much coinsurance does the insured pay?

    1. A. $20
    2. B. $100
    3. C. $400
    4. D. $500

    Answer: B

    Explanation: "Coinsurance: The percentage of the cost of a covered health care service you pay (20%, for example) after you’ve met your deductible." With the deductible met, the insured owes 20% × $500 = $100. The other figures confuse rate with dollars, use the insurer's 80% share, or charge the whole allowed amount.

    Reference: Maryland Insurance Administration Health Plan Terms Glossary — Health Plan Terms Glossary, Coinsurance

  7. 7Under Maryland small-employer rules, an employee regularly working how many hours weekly is generally full-time?

    1. A. 20 or more
    2. B. 30 or more
    3. C. 35 or more
    4. D. 40 or more

    Answer: B

    Explanation: The controlling official text states "at least 30 hours per week". Section 15-1201 therefore classifies that employee as full-time.

    Reference: Article - Insurance — §15-1201, full-time employee

  8. 8A dental plan claim involves treatment of diseased tooth pulp and tissues around the root. Which dental specialty best classifies that treatment?

    1. A. Endodontics
    2. B. Periodontics
    3. C. Prosthodontics
    4. D. Orthodontics

    Answer: A

    Explanation: "Endodontics is the dental specialty which is concerned with the morphology, biology, physiology, pathology and regeneration of the human dental pulp" Endodontics concerns dental pulp and periradicular tissue. The other specialties focus on supporting tissues, replacement of missing teeth, or malocclusion.

    Reference: National Commission on Recognition of Dental Specialties, Recognized Dental Specialties — Recognized Dental Specialties, Endodontics

  9. 9In which numbered month does Maryland's six-month Medicare supplement open enrollment begin once a person is at least 65 and enrolled in Part B?

    1. A. The 1st qualifying month
    2. B. The 2nd qualifying month
    3. C. The 3rd qualifying month
    4. D. The 6th qualifying month

    Answer: A

    Explanation: The controlling official text states "6-month period". Section 15-909 begins the six-month period with the first month the individual is at least 65 and enrolled in Part B.

    Reference: Article - Insurance — §15-909

  10. 10An individual pays the entire premium for a disability income policy with after-tax funds and later receives disability benefits. How are those benefits generally treated for federal income tax?

    1. A. Excluded from taxable income
    2. B. Fully included as taxable income
    3. C. Taxable in proportion to employer-paid premiums
    4. D. Taxable only after all premiums are recovered

    Answer: A

    Explanation: "If you pay the entire cost of a health or accident insurance plan on an after-tax basis, don't include any amounts you receive for your disability as income on your tax return." With the entire premium personally paid after tax, the IRS says not to include benefits in income. Employer-paid and mixed-premium arrangements have different rules.

    Reference: IRS Life Insurance & Disability Insurance Proceeds FAQ — FAQ, taxable disability proceeds

Topics in this practice bank

These topics describe the available practice for Accident and Health or Sickness Producer. Review the examination outline and its sources for scope and allocation details.

  • 1.0 Insurance Regulation 30% (24 items)
    • 1.1 Licensing
    • 1.1 Licensing > General Provisions and Definitions
    • 1.1 Licensing > Purpose
    • 1.1 Licensing > Process (Insurance Article Annotated Code- Sec. 10-118(b)(2); Sec. 10-103(c)(1))
    • 1.1 Licensing > Process (Insurance Article Annotated Code- Sec. 10-118(b)(2); Sec. 10-103(c)(1)) > Initial Licensure Qualifications
    • 1.1 Licensing > Process (Insurance Article Annotated Code- Sec. 10-118(b)(2); Sec. 10-103(c)(1)) > Examination
    • 1.1 Licensing > Process (Insurance Article Annotated Code- Sec. 10-118(b)(2); Sec. 10-103(c)(1)) > License fee & application
    • 1.1 Licensing > Types of licensees (Insurance Article Annotated Code- Sec. 1-101(u)(1))
    • 1.1 Licensing > Types of licensees (Insurance Article Annotated Code- Sec. 1-101(u)(1)) > Producers
    • 1.1 Licensing > Types of licensees (Insurance Article Annotated Code- Sec. 1-101(u)(1)) > Advisers
    • 1.1 Licensing > Types of licensees (Insurance Article Annotated Code- Sec. 1-101(u)(1)) > Nonresidents
    • 1.1 Licensing > Types of licensees (Insurance Article Annotated Code- Sec. 1-101(u)(1)) > Business entities
    • 1.1 Licensing > Types of licensees (Insurance Article Annotated Code- Sec. 1-101(u)(1)) > Exceptions
    • 1.1 Licensing > Maintenance (Insurance Article Annotated Code- Sec. 10- 211(e)(2)(i); Sec. 10-115; Sec. 10-1-05; Sect. 10- 116(a)(2)(i);))
    • 1.1 Licensing > Maintenance (Insurance Article Annotated Code- Sec. 10- 211(e)(2)(i); Sec. 10-115; Sec. 10-1-05; Sect. 10- 116(a)(2)(i);)) > Duration and termination
    • 1.1 Licensing > Maintenance (Insurance Article Annotated Code- Sec. 10- 211(e)(2)(i); Sec. 10-115; Sec. 10-1-05; Sect. 10- 116(a)(2)(i);)) > Address and/or name changes
    • 1.1 Licensing > Maintenance (Insurance Article Annotated Code- Sec. 10- 211(e)(2)(i); Sec. 10-115; Sec. 10-1-05; Sect. 10- 116(a)(2)(i);)) > Assumed names
    • 1.1 Licensing > Maintenance (Insurance Article Annotated Code- Sec. 10- 211(e)(2)(i); Sec. 10-115; Sec. 10-1-05; Sect. 10- 116(a)(2)(i);)) > Requirement to report felony convictions
    • 1.1 Licensing > Maintenance (Insurance Article Annotated Code- Sec. 10- 211(e)(2)(i); Sec. 10-115; Sec. 10-1-05; Sect. 10- 116(a)(2)(i);)) > Requirement to report other states actions
    • 1.1 Licensing > Maintenance (Insurance Article Annotated Code- Sec. 10- 211(e)(2)(i); Sec. 10-115; Sec. 10-1-05; Sect. 10- 116(a)(2)(i);)) > Continuing education
    • 1.1 Licensing > Appointment procedures (Insurance Article Annotated Code- Sec. 1-101; Sec. 10- 118; Sec. 27-209)
    • 1.1 Licensing > Appointment procedures (Insurance Article Annotated Code- Sec. 1-101; Sec. 10- 118; Sec. 27-209) > Producer's contract with insurer versus producer's appointment with insurer
    • 1.1 Licensing > Appointment procedures (Insurance Article Annotated Code- Sec. 1-101; Sec. 10- 118; Sec. 27-209) > Producer's appointment versus agency's appointment
    • 1.1 Licensing > Appointment procedures (Insurance Article Annotated Code- Sec. 1-101; Sec. 10- 118; Sec. 27-209) > Solicitation prior to appointment
    • 1.1 Licensing > Appointment procedures (Insurance Article Annotated Code- Sec. 1-101; Sec. 10- 118; Sec. 27-209) > Appointment requirement after becoming licensed
    • 1.1 Licensing > Appointment procedures (Insurance Article Annotated Code- Sec. 1-101; Sec. 10- 118; Sec. 27-209) > Acknowledgment of appointment/notice to producer
    • 1.1 Licensing > Appointment procedures (Insurance Article Annotated Code- Sec. 1-101; Sec. 10- 118; Sec. 27-209) > Requirement to cease solicitation
    • 1.1 Licensing > Appointment procedures (Insurance Article Annotated Code- Sec. 1-101; Sec. 10- 118; Sec. 27-209) > Termination of appointment/notice to producer
    • 1.1 Licensing > Appointment procedures (Insurance Article Annotated Code- Sec. 1-101; Sec. 10- 118; Sec. 27-209) > Termination of license without active appointment
    • 1.1 Licensing > Disciplinary actions (Insurance Article Annotated Code- Sec. 1-301; Sec. 10- 126; Sec. 27-202)
    • 1.1 Licensing > Disciplinary actions (Insurance Article Annotated Code- Sec. 1-301; Sec. 10- 126; Sec. 27-202) > Probation, suspension, revocation or refusal to issue or renew
    • 1.1 Licensing > Disciplinary actions (Insurance Article Annotated Code- Sec. 1-301; Sec. 10- 126; Sec. 27-202) > Cease and desist order
    • 1.1 Licensing > Disciplinary actions (Insurance Article Annotated Code- Sec. 1-301; Sec. 10- 126; Sec. 27-202) > Penalties
    • 1.1 Licensing > Disciplinary actions (Insurance Article Annotated Code- Sec. 1-301; Sec. 10- 126; Sec. 27-202) > Hearings/Notice of Hearings
    • 1.1 Licensing > Fraud (Insurance Article Annotated Code- Sec. 27- 216(a)(1)(i); Sec. 2-401)
    • 1.2 State regulation
    • 1.2 State regulation > Maryland Insurance Administration's general duties and powers (Insurance Article Annotated Code- Sec. 2-102(a); Sec. 2-103(a)(4); Sec. 2-204(b)(1); Sec. 14- 404, 16-601; Sec. 1- 301; Sec. 2-101)
    • 1.2 State regulation > Producer regulation (Insurance Article Annotated Code- Sec. 27-209; Sec. 10-105; COMAR- Sec. 31.03.03)
    • 1.2 State regulation > Producer regulation (Insurance Article Annotated Code- Sec. 27-209; Sec. 10-105; COMAR- Sec. 31.03.03) > Acting for an unlicensed insurer
    • 1.2 State regulation > Producer regulation (Insurance Article Annotated Code- Sec. 27-209; Sec. 10-105; COMAR- Sec. 31.03.03) > Record retention
    • 1.2 State regulation > Producer regulation (Insurance Article Annotated Code- Sec. 27-209; Sec. 10-105; COMAR- Sec. 31.03.03) > Activities of unlicensed individuals
    • 1.2 State regulation > Producer regulation (Insurance Article Annotated Code- Sec. 27-209; Sec. 10-105; COMAR- Sec. 31.03.03) > Payment and sharing of commissions
    • 1.2 State regulation > Producer regulation (Insurance Article Annotated Code- Sec. 27-209; Sec. 10-105; COMAR- Sec. 31.03.03) > Charging of fees
    • 1.2 State regulation > Producer regulation (Insurance Article Annotated Code- Sec. 27-209; Sec. 10-105; COMAR- Sec. 31.03.03) > Illegal compensation; exceptions
    • 1.2 State regulation > Producer regulation (Insurance Article Annotated Code- Sec. 27-209; Sec. 10-105; COMAR- Sec. 31.03.03) > Fiduciary capacity
    • 1.2 State regulation > Producer regulation (Insurance Article Annotated Code- Sec. 27-209; Sec. 10-105; COMAR- Sec. 31.03.03) > Responsibility of trust accounts
    • 1.2 State regulation > Unfair trade practices (Insurance Article Annotated Code- Sec. 27-304 Sec. 27-213; Sec. 27-305(a); Sec. 27-504(b)(1))
    • 1.2 State regulation > Unfair trade practices (Insurance Article Annotated Code- Sec. 27-304 Sec. 27-213; Sec. 27-305(a); Sec. 27-504(b)(1)) > Misrepresentation
    • 1.2 State regulation > Unfair trade practices (Insurance Article Annotated Code- Sec. 27-304 Sec. 27-213; Sec. 27-305(a); Sec. 27-504(b)(1)) > False advertising
    • 1.2 State regulation > Unfair trade practices (Insurance Article Annotated Code- Sec. 27-304 Sec. 27-213; Sec. 27-305(a); Sec. 27-504(b)(1)) > Defamation
    • 1.2 State regulation > Unfair trade practices (Insurance Article Annotated Code- Sec. 27-304 Sec. 27-213; Sec. 27-305(a); Sec. 27-504(b)(1)) > Notice of Adverse Underwriting Decisions
    • 1.2 State regulation > Unfair trade practices (Insurance Article Annotated Code- Sec. 27-304 Sec. 27-213; Sec. 27-305(a); Sec. 27-504(b)(1)) > False statements and entries
    • 1.2 State regulation > Unfair trade practices (Insurance Article Annotated Code- Sec. 27-304 Sec. 27-213; Sec. 27-305(a); Sec. 27-504(b)(1)) > Rebating
    • 1.2 State regulation > Unfair trade practices (Insurance Article Annotated Code- Sec. 27-304 Sec. 27-213; Sec. 27-305(a); Sec. 27-504(b)(1)) > Twisting
    • 1.2 State regulation > Unfair trade practices (Insurance Article Annotated Code- Sec. 27-304 Sec. 27-213; Sec. 27-305(a); Sec. 27-504(b)(1)) > Referrals
    • 1.2 State regulation > Insurance information and privacy protection
    • 1.3 Providers
    • 1.3 Providers > Types of Providers
    • 1.3 Providers > Types of Providers > Insurers (Annotated Code- Sec. 1-101)
    • 1.3 Providers > Types of Providers > Non Profits Health Service Plans (Insurance Article Annotated Code- Sec. 14-101 and 14- 102)
    • 1.3 Providers > Types of Providers > Health Maintenance Organizations (HMOs) (COMAR Sec. 31.12.07.02(B)(3); Health General Article Annotated Code-Title 19 Subtitle 7- Sec. 19-701; Sec. 19-705)
    • 1.4 Plan requirements
    • 1.4 Plan requirements > Eligibility requirements
    • 1.4 Plan requirements > Eligibility requirements > Dependent child age limit
    • 1.4 Plan requirements > Eligibility requirements > Coverage for adopted children
    • 1.4 Plan requirements > Eligibility requirements > Newborn child coverage
    • 1.4 Plan requirements > Eligibility requirements > Medical child support coverage
    • 1.4 Plan requirements > Eligibility requirements > Intellectual disability and physical handicap dependent coverage
    • 1.4 Plan requirements > Mandated or Required Offers (Insurance Article Annotated Code- Sec. 15-407, 15- 408, 15-409; Sec. 15-801, 15-802, 15-810, 15-839)
    • 1.4 Plan requirements > Mandated or Required Benefits (COMAR Sec. 31.10.06.08(B)(12); Insurance Article Annotated Code- Sec. 15-804(3); Sec. 15- 802, 15-838, 15- 841)
    • 1.4 Plan requirements > Other Requirements
    • 1.4 Plan requirements > Small Employer Health Insurance (Insurance Article Annotated Code- Sec. 15-1204 (special note)(b); Sec. 15-1205; Sec. 15-1208(C); Sec. 15- 1201(e))
    • 1.4 Plan requirements > Medicare Supplement Insurance (Insurance Article Annotated Code- Sec. 15-901; Sec. 15-906; Sec. 15-909; Sec. 15-910)
    • 1.4 Plan requirements > Medicare Supplement Insurance (Insurance Article Annotated Code- Sec. 15-901; Sec. 15-906; Sec. 15-909; Sec. 15-910) > Purpose and Definitions
    • 1.4 Plan requirements > Medicare Supplement Insurance (Insurance Article Annotated Code- Sec. 15-901; Sec. 15-906; Sec. 15-909; Sec. 15-910) > Minimum Standards and Provisions
    • 1.4 Plan requirements > Medicare Supplement Insurance (Insurance Article Annotated Code- Sec. 15-901; Sec. 15-906; Sec. 15-909; Sec. 15-910) > Eligibility
    • 1.4 Plan requirements > Medicare Supplement Insurance (Insurance Article Annotated Code- Sec. 15-901; Sec. 15-906; Sec. 15-909; Sec. 15-910) > Disclosure and Marketing
    • 1.4 Plan requirements > Maryland Health Benefit Exchange
    • 1.4 Plan requirements > Maryland Health Benefit Exchange > SHOP vs. Individual Exchange
    • 1.4 Plan requirements > Maryland Health Benefit Exchange > Open Enrollment/Special Enrollment
    • 1.4 Plan requirements > Maryland Health Benefit Exchange > Employer Choice Options in SHOP Exchange
    • 1.4 Plan requirements > Maryland Health Benefit Exchange > Mandated Referrals
    • 1.5 Insurance for Senior Citizens and Special Needs Individuals
    • 1.5 Insurance for Senior Citizens and Special Needs Individuals > Maryland Long-Term Care (LTC) regulations and required provisions (Tax General Article 10-710 - Sec. 10-718; Insurance Article Annotated Code- Sec. 18-101; Sec. 18- 104; Sec. 18-105)
    • 1.5 Insurance for Senior Citizens and Special Needs Individuals > Maryland Long-Term Care (LTC) regulations and required provisions (Tax General Article 10-710 - Sec. 10-718; Insurance Article Annotated Code- Sec. 18-101; Sec. 18- 104; Sec. 18-105) > Standards for marketing
    • 1.5 Insurance for Senior Citizens and Special Needs Individuals > Maryland Long-Term Care (LTC) regulations and required provisions (Tax General Article 10-710 - Sec. 10-718; Insurance Article Annotated Code- Sec. 18-101; Sec. 18- 104; Sec. 18-105) > Advertising
    • 1.5 Insurance for Senior Citizens and Special Needs Individuals > Consumer guide
    • 1.5 Insurance for Senior Citizens and Special Needs Individuals > Outline of coverage
    • 1.5 Insurance for Senior Citizens and Special Needs Individuals > Suitability including personal worksheet
    • 1.5 Insurance for Senior Citizens and Special Needs Individuals > Right to return (free look)
    • 1.5 Insurance for Senior Citizens and Special Needs Individuals > Replacement
    • 1.5 Insurance for Senior Citizens and Special Needs Individuals > Renewal considerations
    • 1.5 Insurance for Senior Citizens and Special Needs Individuals > Continuation of benefits
    • 1.5 Insurance for Senior Citizens and Special Needs Individuals > Required disclosure provisions
    • 1.5 Insurance for Senior Citizens and Special Needs Individuals > Incontestability
    • 1.5 Insurance for Senior Citizens and Special Needs Individuals > Inflation protection
    • 1.5 Insurance for Senior Citizens and Special Needs Individuals > Unintentional lapse
    • 1.5 Insurance for Senior Citizens and Special Needs Individuals > Pre-existing conditions
    • 1.5 Insurance for Senior Citizens and Special Needs Individuals > Nonforfeiture benefit
    • 1.5 Insurance for Senior Citizens and Special Needs Individuals > Benefit triggers
    • 1.5 Insurance for Senior Citizens and Special Needs Individuals > Long-Term Care (LTC)Insurance
    • 1.5 Insurance for Senior Citizens and Special Needs Individuals > Long-Term Care (LTC)Insurance > Deductibility of Premiums for LTC Insurance for State Income Tax Purposes
    • 1.5 Insurance for Senior Citizens and Special Needs Individuals > Maryland Medicare Supplement regulations and required provisions
    • 1.5 Insurance for Senior Citizens and Special Needs Individuals > Maryland Medicare Supplement regulations and required provisions > Standards for marketing
    • 1.5 Insurance for Senior Citizens and Special Needs Individuals > Maryland Medicare Supplement regulations and required provisions > Advertising
    • 1.5 Insurance for Senior Citizens and Special Needs Individuals > Maryland Medicare Supplement regulations and required provisions > Appropriateness of recommended purchase and excessive insurance
    • 1.5 Insurance for Senior Citizens and Special Needs Individuals > Maryland Medicare Supplement regulations and required provisions > Buyer's guide
    • 1.5 Insurance for Senior Citizens and Special Needs Individuals > Maryland Medicare Supplement regulations and required provisions > Outline of coverage
    • 1.5 Insurance for Senior Citizens and Special Needs Individuals > Maryland Medicare Supplement regulations and required provisions > Right to return (free look)
    • 1.5 Insurance for Senior Citizens and Special Needs Individuals > Maryland Medicare Supplement regulations and required provisions > Replacement
    • 1.5 Insurance for Senior Citizens and Special Needs Individuals > Maryland Medicare Supplement regulations and required provisions > Prohibited policy provisions
    • 1.5 Insurance for Senior Citizens and Special Needs Individuals > Maryland Medicare Supplement regulations and required provisions > Minimum benefit standards
    • 1.5 Insurance for Senior Citizens and Special Needs Individuals > Maryland Medicare Supplement regulations and required provisions > Required disclosure provisions
    • 1.5 Insurance for Senior Citizens and Special Needs Individuals > Maryland Medicare Supplement regulations and required provisions > Pre-existing conditions
    • 1.5 Insurance for Senior Citizens and Special Needs Individuals > Maryland Medicare Supplement regulations and required provisions > Permitted compensation
    • 1.5 Insurance for Senior Citizens and Special Needs Individuals > Maryland Medicare Supplement regulations and required provisions > Guaranteed issue for eligible persons
    • 1.5 Insurance for Senior Citizens and Special Needs Individuals > Maryland Medicare Supplement regulations and required provisions > Continuation and conversion requirements
    • 1.5 Insurance for Senior Citizens and Special Needs Individuals > Maryland Medicare Supplement regulations and required provisions > Medicare SELECT
  • 2.0 General Insurance 9% (7 items)
    • 2.1 Concepts
    • 2.1 Concepts > Risk management key terms
    • 2.1 Concepts > Risk management key terms > Risk
    • 2.1 Concepts > Risk management key terms > Exposure
    • 2.1 Concepts > Risk management key terms > Hazard
    • 2.1 Concepts > Risk management key terms > Peril
    • 2.1 Concepts > Risk management key terms > Loss
    • 2.1 Concepts > Methods of handling risk
    • 2.1 Concepts > Methods of handling risk > Avoidance
    • 2.1 Concepts > Methods of handling risk > Retention
    • 2.1 Concepts > Methods of handling risk > Sharing
    • 2.1 Concepts > Methods of handling risk > Reduction
    • 2.1 Concepts > Methods of handling risk > Transfer
    • 2.1 Concepts > Elements of insurable risks
    • 2.1 Concepts > Adverse selection
    • 2.1 Concepts > Law of large numbers
    • 2.1 Concepts > Reinsurance
    • 2.2 Insurers
    • 2.2 Insurers > Types of insurers
    • 2.2 Insurers > Types of insurers > Stock companies
    • 2.2 Insurers > Types of insurers > Mutual companies
    • 2.2 Insurers > Types of insurers > Fraternal benefit societies
    • 2.2 Insurers > Types of insurers > Self insurers
    • 2.2 Insurers > Private versus government insurers
    • 2.2 Insurers > Admitted versus nonadmitted insurers
    • 2.2 Insurers > Domestic, foreign and alien insurers
    • 2.2 Insurers > Financial status (independent rating services) and operating results
    • 2.2 Insurers > Marketing (distribution) systems
    • 2.3 Producer and general rules of agency
    • 2.3 Producer and general rules of agency > Types
    • 2.3 Producer and general rules of agency > Types > Captive
    • 2.3 Producer and general rules of agency > Types > Independent
    • 2.3 Producer and general rules of agency > Insurer as principal
    • 2.3 Producer and general rules of agency > Producer of insurer
    • 2.3 Producer and general rules of agency > Authority and powers of producers
    • 2.3 Producer and general rules of agency > Authority and powers of producers > Express
    • 2.3 Producer and general rules of agency > Authority and powers of producers > Implied
    • 2.3 Producer and general rules of agency > Authority and powers of producers > Apparent
    • 2.3 Producer and general rules of agency > Responsibilities to the applicant/insured
    • 2.4 Contracts
    • 2.4 Contracts > Elements of a legal contract
    • 2.4 Contracts > Elements of a legal contract > Offer and acceptance
    • 2.4 Contracts > Elements of a legal contract > Consideration
    • 2.4 Contracts > Elements of a legal contract > Competent parties
    • 2.4 Contracts > Elements of a legal contract > Legal purpose
    • 2.4 Contracts > Distinct characteristics of an insurance contract
    • 2.4 Contracts > Distinct characteristics of an insurance contract > Contract of adhesion
    • 2.4 Contracts > Distinct characteristics of an insurance contract > Aleatory contract
    • 2.4 Contracts > Distinct characteristics of an insurance contract > Personal contract
    • 2.4 Contracts > Distinct characteristics of an insurance contract > Unilateral contract
    • 2.4 Contracts > Distinct characteristics of an insurance contract > Conditional contract
    • 2.4 Contracts > Legal interpretations affecting contracts
    • 2.4 Contracts > Legal interpretations affecting contracts > Ambiguities in a contract of adhesion
    • 2.4 Contracts > Legal interpretations affecting contracts > Reasonable expectations
    • 2.4 Contracts > Legal interpretations affecting contracts > Indemnity
    • 2.4 Contracts > Legal interpretations affecting contracts > Utmost good faith
    • 2.4 Contracts > Legal interpretations affecting contracts > Representations/misrepresentations
    • 2.4 Contracts > Legal interpretations affecting contracts > Warranties
    • 2.4 Contracts > Legal interpretations affecting contracts > Concealment
    • 2.4 Contracts > Legal interpretations affecting contracts > Fraud
    • 2.4 Contracts > Legal interpretations affecting contracts > Waiver and estoppel
    • 2.5 Federal regulation
    • 2.5 Federal regulation > Fair Credit Reporting Act (15 USC 1681–1681d)
    • 2.5 Federal regulation > Fraud and false statements (18 USC 1033, 1034)
    • 2.5 Federal regulation > Employee Retirement Income Security Act (ERISA)
    • 2.5 Federal regulation > Employee Retirement Income Security Act (ERISA) > Applicability
    • 2.5 Federal regulation > Employee Retirement Income Security Act (ERISA) > Fiduciary responsibilities
    • 2.5 Federal regulation > Employee Retirement Income Security Act (ERISA) > Reporting and disclosure
    • 2.5 Federal regulation > COBRA
    • 2.5 Federal regulation > Continuation
    • 2.5 Federal regulation > ACA-Related Federal Market Reforms
    • 2.5 Federal regulation > ACA-Related Federal Market Reforms > Definitions
    • 2.5 Federal regulation > ACA-Related Federal Market Reforms > Definitions > Individual health insurance coverage
    • 2.5 Federal regulation > ACA-Related Federal Market Reforms > Dependent coverage
    • 2.5 Federal regulation > ACA-Related Federal Market Reforms > Lifetime and annual limits
    • 2.5 Federal regulation > ACA-Related Federal Market Reforms > Restrictions relating to premium rates
    • 2.5 Federal regulation > ACA-Related Federal Market Reforms > Essential health benefits
    • 2.5 Federal regulation > ACA-Related Federal Market Reforms > Waiting periods
    • 2.6 Industry regulation
    • 2.6 Industry regulation > National Association of Insurance Commissioners (NAIC)
  • 3.0 Health Insurance Basics 11% (9 items)
    • 3.1 Definitions of perils
    • 3.1 Definitions of perils > Accidental injury
    • 3.1 Definitions of perils > Sickness
    • 3.2 Principal types of losses and benefits
    • 3.2 Principal types of losses and benefits > Loss of income from disability
    • 3.2 Principal types of losses and benefits > Medical expense
    • 3.2 Principal types of losses and benefits > Dental expense
    • 3.2 Principal types of losses and benefits > Long-term care expense
    • 3.2 Principal types of losses and benefits > Vision
    • 3.2 Principal types of losses and benefits > Prescription
    • 3.2 Principal types of losses and benefits > AD&D (Accidental Death and Dismemberment)
    • 3.2 Principal types of losses and benefits > Specified Disease
    • 3.3 Classes of health insurance policies
    • 3.3 Classes of health insurance policies > Individual versus group
    • 3.3 Classes of health insurance policies > Private versus government
    • 3.3 Classes of health insurance policies > Limited versus comprehensive
    • 3.4 Limited policies
    • 3.4 Limited policies > Limited perils and amounts
    • 3.4 Limited policies > Required notice to insured
    • 3.4 Limited policies > Types of limited policies
    • 3.4 Limited policies > Types of limited policies > Accident-only
    • 3.4 Limited policies > Types of limited policies > Specified (dread) disease
    • 3.4 Limited policies > Types of limited policies > Hospital indemnity (income)
    • 3.4 Limited policies > Types of limited policies > Credit disability
    • 3.4 Limited policies > Types of limited policies > Blanket insurance (teams, passengers, other)
    • 3.4 Limited policies > Types of limited policies > Prescription drugs
    • 3.4 Limited policies > Types of limited policies > Vision care
    • 3.4 Limited policies > Types of limited policies > Critical illness (specified conditions)
    • 3.4 Limited policies > Types of limited policies > Short-term medical
    • 3.5 Common exclusions from coverage
    • 3.5 Common exclusions from coverage > Pre-existing conditions
    • 3.5 Common exclusions from coverage > Intentionally self-inflicted injuries
    • 3.5 Common exclusions from coverage > War or act of war
    • 3.5 Common exclusions from coverage > Elective cosmetic surgery
    • 3.5 Common exclusions from coverage > Conditions covered by workers compensation
    • 3.5 Common exclusions from coverage > Government plans
    • 3.5 Common exclusions from coverage > Participation in a felony or illegal occupation
    • 3.6 Producer responsibilities in individual health insurance
    • 3.6 Producer responsibilities in individual health insurance > Marketing requirements
    • 3.6 Producer responsibilities in individual health insurance > Marketing requirements > Advertising
    • 3.6 Producer responsibilities in individual health insurance > Marketing requirements > Prohibited Advertising of Life and Health Insurance
    • 3.6 Producer responsibilities in individual health insurance > Marketing requirements > Maryland Life and Health Insurance Guaranty Corporation
    • 3.6 Producer responsibilities in individual health insurance > Marketing requirements > Sales presentations
    • 3.6 Producer responsibilities in individual health insurance > Field underwriting
    • 3.6 Producer responsibilities in individual health insurance > Field underwriting > Nature and purpose
    • 3.6 Producer responsibilities in individual health insurance > Field underwriting > Application procedures
    • 3.6 Producer responsibilities in individual health insurance > Field underwriting > Requirements at delivery of policy
    • 3.6 Producer responsibilities in individual health insurance > Errors and Omissions
    • 3.6 Producer responsibilities in individual health insurance > Notification of Medicare eligibility
    • 3.7 Individual underwriting by the insurer
    • 3.7 Individual underwriting by the insurer > Underwriting Criteria
    • 3.7 Individual underwriting by the insurer > Sources of underwriting information
    • 3.7 Individual underwriting by the insurer > Sources of underwriting information > Application
    • 3.7 Individual underwriting by the insurer > Sources of underwriting information > Producer report
    • 3.7 Individual underwriting by the insurer > Sources of underwriting information > Attending physician statement
    • 3.7 Individual underwriting by the insurer > Sources of underwriting information > Investigative consumer (inspection) report
    • 3.7 Individual underwriting by the insurer > Sources of underwriting information > Medical Information Bureau (MIB)
    • 3.7 Individual underwriting by the insurer > Sources of underwriting information > Medical examinations and lab tests (including HIV consent)
    • 3.7 Individual underwriting by the insurer > Unfair discrimination
    • 3.7 Individual underwriting by the insurer > Discrimination against victims of domestic violence
    • 3.7 Individual underwriting by the insurer > Genetic information privacy
    • 3.7 Individual underwriting by the insurer > Classification of risks
    • 3.7 Individual underwriting by the insurer > Classification of risks > Preferred
    • 3.7 Individual underwriting by the insurer > Classification of risks > Standard
    • 3.7 Individual underwriting by the insurer > Classification of risks > Substandard
    • 3.7 Individual underwriting by the insurer > Classification of risks > Declined
    • 3.8 Considerations in replacing health insurance
    • 3.8 Considerations in replacing health insurance > Pre-existing conditions
    • 3.8 Considerations in replacing health insurance > Pre-existing condition exclusion
    • 3.8 Considerations in replacing health insurance > Benefits, limitations and exclusions
    • 3.8 Considerations in replacing health insurance > Underwriting requirements
  • 4.0 Individual Health Insurance Policy General Provisions 8% (6 items)
    • 4.1 Uniform required provisions
    • 4.1 Uniform required provisions > Entire contract; changes
    • 4.1 Uniform required provisions > Time limit on certain defenses
    • 4.1 Uniform required provisions > Grace period
    • 4.1 Uniform required provisions > Reinstatement
    • 4.1 Uniform required provisions > Notice of claim
    • 4.1 Uniform required provisions > Claim forms
    • 4.1 Uniform required provisions > Proofs of loss
    • 4.1 Uniform required provisions > Time of payment of claims
    • 4.1 Uniform required provisions > Payment of claims
    • 4.1 Uniform required provisions > Physical examinations and autopsy
    • 4.1 Uniform required provisions > Legal actions
    • 4.1 Uniform required provisions > Change of beneficiary
    • 4.1 Uniform required provisions > Cancellation by insured
    • 4.2 Uniform optional provisions
    • 4.2 Uniform optional provisions > Change of occupation
    • 4.2 Uniform optional provisions > Misstatement of age
    • 4.2 Uniform optional provisions > Other insurance in this company
    • 4.2 Uniform optional provisions > Insurance with other companies
    • 4.2 Uniform optional provisions > Insurance with other companies > Expense-incurred basis
    • 4.2 Uniform optional provisions > Insurance with other companies > Other benefits
    • 4.2 Uniform optional provisions > Relation of Earnings to Insurance
    • 4.2 Uniform optional provisions > Unpaid premium
    • 4.2 Uniform optional provisions > Cancellation by company
    • 4.2 Uniform optional provisions > Conformity with state statutes
    • 4.2 Uniform optional provisions > Illegal occupation
    • 4.2 Uniform optional provisions > Intoxicants and narcotics
    • 4.3 Other general provisions
    • 4.3 Other general provisions > Right to examine (free look)
    • 4.3 Other general provisions > Insuring clause
    • 4.3 Other general provisions > Consideration clause
    • 4.3 Other general provisions > Renewability clause
    • 4.3 Other general provisions > Renewability clause > Noncancelable
    • 4.3 Other general provisions > Renewability clause > Guaranteed renewable
    • 4.3 Other general provisions > Renewability clause > Conditionally renewable
    • 4.3 Other general provisions > Renewability clause > Renewable at option of insurer
    • 4.3 Other general provisions > Renewability clause > Nonrenewable (cancelable, term)
    • 4.3 Other general provisions > Interest on claim proceeds
    • 4.3 Other general provisions > Military suspension provision
  • 5.0 Disability Income and Related Insurance 9% (7 items)
    • 5.1 Qualifying for disability benefits
    • 5.1 Qualifying for disability benefits > Inability to perform duties
    • 5.1 Qualifying for disability benefits > Inability to perform duties > Own occupation
    • 5.1 Qualifying for disability benefits > Inability to perform duties > Any occupation
    • 5.1 Qualifying for disability benefits > Pure loss of income (income replacement contracts)
    • 5.1 Qualifying for disability benefits > Presumptive disability
    • 5.1 Qualifying for disability benefits > Requirement to be under physician care
    • 5.2 Individual disability income insurance
    • 5.2 Individual disability income insurance > Basic total disability plan
    • 5.2 Individual disability income insurance > Basic total disability plan > Income benefits (monthly indemnity)
    • 5.2 Individual disability income insurance > Basic total disability plan > Elimination and benefit periods
    • 5.2 Individual disability income insurance > Basic total disability plan > Waiver of premium benefit
    • 5.2 Individual disability income insurance > Partial Disability Insurance
    • 5.2 Individual disability income insurance > Partial Disability Insurance > Income Benefits (Monthly Indemnities)
    • 5.2 Individual disability income insurance > Partial Disability Insurance > Elimination and Benefit Periods
    • 5.2 Individual disability income insurance > Partial Disability Insurance > Waiver of Premium Benefit
    • 5.2 Individual disability income insurance > Coordination with Social Insurance
    • 5.2 Individual disability income insurance > Coordination with Social Insurance > Additional monthly benefit (AMB)
    • 5.2 Individual disability income insurance > Coordination with Social Insurance > Social insurance supplement (SIS)
    • 5.2 Individual disability income insurance > Coordination with Social Insurance > Occupational versus nonoccupational coverage
    • 5.2 Individual disability income insurance > At-work benefits
    • 5.2 Individual disability income insurance > At-work benefits > Partial disability benefit
    • 5.2 Individual disability income insurance > At-work benefits > Residual disability benefit
    • 5.2 Individual disability income insurance > Other provisions affecting income benefits
    • 5.2 Individual disability income insurance > Other provisions affecting income benefits > Cost of living adjustment (COLA) rider
    • 5.2 Individual disability income insurance > Other provisions affecting income benefits > Future increase option (FIO) rider
    • 5.2 Individual disability income insurance > Other provisions affecting income benefits > Annual renewable term rider
    • 5.2 Individual disability income insurance > Other provisions affecting income benefits > Relation of earnings to insurance
    • 5.2 Individual disability income insurance > Other provisions affecting income benefits > Change of occupation
    • 5.2 Individual disability income insurance > Other cash benefits
    • 5.2 Individual disability income insurance > Other cash benefits > Accidental death and dismemberment
    • 5.2 Individual disability income insurance > Other cash benefits > Rehabilitation benefit
    • 5.2 Individual disability income insurance > Other cash benefits > Medical reimbursement benefit (nondisabling injury)
    • 5.2 Individual disability income insurance > Refund provisions
    • 5.2 Individual disability income insurance > Refund provisions > Return of premium
    • 5.2 Individual disability income insurance > Refund provisions > Cash value benefit
    • 5.2 Individual disability income insurance > Exclusions
    • 5.2 Individual disability income insurance > Waiver of Premium
    • 5.3 Unique aspects of individual disability underwriting
    • 5.3 Unique aspects of individual disability underwriting > Occupational considerations
    • 5.3 Unique aspects of individual disability underwriting > Benefit limits
    • 5.3 Unique aspects of individual disability underwriting > Policy issuance alternatives
    • 5.4 Group disability income insurance
    • 5.4 Group disability income insurance > Group versus individual plans
    • 5.4 Group disability income insurance > Short-term disability (STD)
    • 5.4 Group disability income insurance > Long-term disability (LTD)
    • 5.5 Business disability insurance
    • 5.5 Business disability insurance > Key employee (partner) disability income
    • 5.5 Business disability insurance > Business overhead expense policy
    • 5.5 Business disability insurance > Business Disability buyout policy
    • 5.6 Social Security disability
    • 5.6 Social Security disability > Qualification for disability benefits
    • 5.6 Social Security disability > Definition of disability
    • 5.6 Social Security disability > Waiting period
    • 5.6 Social Security disability > Disability income benefits
    • 5.7 Workers compensation
    • 5.7 Workers compensation > Eligibility
    • 5.7 Workers compensation > Benefits
  • 6.0 Medical Plans 14% (11 items)
    • 6.1 Medical plan concepts
    • 6.1 Medical plan concepts > Fee-for-service basis versus prepaid basis
    • 6.1 Medical plan concepts > Prepaid Basis
    • 6.1 Medical plan concepts > Specified coverages versus comprehensive care
    • 6.1 Medical plan concepts > Comprehensive Care
    • 6.1 Medical plan concepts > Benefit schedule versus usual/reasonable/customary charges
    • 6.1 Medical plan concepts > Usual - Reasonable - Customary Charges
    • 6.1 Medical plan concepts > Any provider versus limited choice of providers
    • 6.1 Medical plan concepts > Limited Choice of Providers
    • 6.1 Medical plan concepts > Insureds versus subscribers/participants
    • 6.2 Types of providers and plans
    • 6.2 Types of providers and plans > Insurers
    • 6.2 Types of providers and plans > Nonprofits Health Service Plans
    • 6.2 Types of providers and plans > Major medical insurance (insurers)
    • 6.2 Types of providers and plans > Major medical insurance (insurers) > Characteristics
    • 6.2 Types of providers and plans > Major medical insurance (insurers) > Common limitations
    • 6.2 Types of providers and plans > Major medical insurance (insurers) > Common exclusions from coverage
    • 6.2 Types of providers and plans > Major medical insurance (insurers) > Deductibles
    • 6.2 Types of providers and plans > Major medical insurance (insurers) > Coinsurance feature
    • 6.2 Types of providers and plans > Major medical insurance (insurers) > Stop-loss feature
    • 6.2 Types of providers and plans > Major medical insurance (insurers) > Maximum benefits
    • 6.2 Types of providers and plans > Fixed Indemnity
    • 6.2 Types of providers and plans > Health services plans
    • 6.2 Types of providers and plans > Health services plans > Definitions
    • 6.2 Types of providers and plans > Health services plans > Plans offered
    • 6.2 Types of providers and plans > Health services plans > Other services
    • 6.2 Types of providers and plans > Health services plans > Qualified providers
    • 6.2 Types of providers and plans > Health services plans > Choice of provider or pharmacy
    • 6.2 Types of providers and plans > Health services plans > Provider panels
    • 6.2 Types of providers and plans > Health services plans > Disclosure of benefits
    • 6.2 Types of providers and plans > Health services plans > Subscribers
    • 6.2 Types of providers and plans > Health maintenance organizations (HMOs)
    • 6.2 Types of providers and plans > Health maintenance organizations (HMOs) > Combined health care delivery and financing
    • 6.2 Types of providers and plans > Health maintenance organizations (HMOs) > Limited service area/out of area benefits
    • 6.2 Types of providers and plans > Health maintenance organizations (HMOs) > Limited choice of providers
    • 6.2 Types of providers and plans > Health maintenance organizations (HMOs) > Gatekeeper concept
    • 6.2 Types of providers and plans > Health maintenance organizations (HMOs) > Copayments
    • 6.2 Types of providers and plans > Health maintenance organizations (HMOs) > Prepaid basis
    • 6.2 Types of providers and plans > Health maintenance organizations (HMOs) > Preventive care services
    • 6.2 Types of providers and plans > Health maintenance organizations (HMOs) > Primary care physician versus referral (specialty) physician
    • 6.2 Types of providers and plans > Health maintenance organizations (HMOs) > Emergency care
    • 6.2 Types of providers and plans > Health maintenance organizations (HMOs) > Hospital services
    • 6.2 Types of providers and plans > Health maintenance organizations (HMOs) > Other basic services
    • 6.2 Types of providers and plans > Health maintenance organizations (HMOs) > Subscribers
    • 6.2 Types of providers and plans > Preferred provider organizations (PPOs)
    • 6.2 Types of providers and plans > Preferred provider organizations (PPOs) > General characteristics
    • 6.2 Types of providers and plans > Preferred provider organizations (PPOs) > Open panel or closed panel
    • 6.2 Types of providers and plans > Point-of-service (POS) plans
    • 6.2 Types of providers and plans > Point-of-service (POS) plans > Nature and purpose
    • 6.2 Types of providers and plans > Point-of-service (POS) plans > Out-of-network provider access (open-ended HMO)
    • 6.2 Types of providers and plans > Point-of-service (POS) plans > PCP referral
    • 6.2 Types of providers and plans > Point-of-service (POS) plans > Indemnity plan features
    • 6.2 Types of providers and plans > TRI-CARE
    • 6.3 Cost containment in health care delivery
    • 6.3 Cost containment in health care delivery > Cost-saving services
    • 6.3 Cost containment in health care delivery > Cost-saving services > Preventive care
    • 6.3 Cost containment in health care delivery > Cost-saving services > Outpatient ambulatory services
    • 6.3 Cost containment in health care delivery > Cost-saving services > Alternatives to hospital services
    • 6.3 Cost containment in health care delivery > Utilization management
    • 6.3 Cost containment in health care delivery > Utilization management > Prospective review
    • 6.3 Cost containment in health care delivery > Utilization management > Concurrent review
    • 6.3 Cost containment in health care delivery > Coordination of Benefits
    • 6.4 HIPAA (Health Insurance Portability and Accountability Act) requirements
    • 6.4 HIPAA (Health Insurance Portability and Accountability Act) requirements > Eligibility
    • 6.4 HIPAA (Health Insurance Portability and Accountability Act) requirements > Guaranteed issue
    • 6.4 HIPAA (Health Insurance Portability and Accountability Act) requirements > Pre-existing conditions
    • 6.4 HIPAA (Health Insurance Portability and Accountability Act) requirements > Creditable coverage
    • 6.4 HIPAA (Health Insurance Portability and Accountability Act) requirements > Renewability
    • 6.5 Health Savings Accounts (HSAs) and Health Reimbursement Accounts (HRAs)
    • 6.5 Health Savings Accounts (HSAs) and Health Reimbursement Accounts (HRAs) > Definition
    • 6.5 Health Savings Accounts (HSAs) and Health Reimbursement Accounts (HRAs) > Eligibility
    • 6.5 Health Savings Accounts (HSAs) and Health Reimbursement Accounts (HRAs) > Contribution limits
    • 6.6 Patient Protection and Affordable Care Act
    • 6.6 Patient Protection and Affordable Care Act > Coverage of Children to Age 26
    • 6.6 Patient Protection and Affordable Care Act > Preventative Care
    • 6.6 Patient Protection and Affordable Care Act > Pre-existing Conditions
    • 6.6 Patient Protection and Affordable Care Act > Lifetime and Annual Limits
    • 6.6 Patient Protection and Affordable Care Act > Grandfathered vs. Non-Grandfathered Plans
    • 6.6 Patient Protection and Affordable Care Act > Rescissions
    • 6.6 Patient Protection and Affordable Care Act > Essential Health Benefits
    • 6.6 Patient Protection and Affordable Care Act > Metal Levels
    • 6.6 Patient Protection and Affordable Care Act > SHOP Payment and Billing
    • 6.6 Patient Protection and Affordable Care Act > Internal Appeal and External Review
    • 6.6 Patient Protection and Affordable Care Act > Subsidies/Tax Credits
    • 6.6 Patient Protection and Affordable Care Act > Penalties and Fines
  • 7.0 Group Health Insurance 5% (4 items)
    • 7.1 Characteristics of group insurance
    • 7.1 Characteristics of group insurance > Group contract
    • 7.1 Characteristics of group insurance > Certificate of coverage
    • 7.1 Characteristics of group insurance > Experience rating versus community rating
    • 7.1 Characteristics of group insurance > Community Rating
    • 7.2 Defined groups
    • 7.2 Defined groups > Employer
    • 7.2 Defined groups > Creditor
    • 7.2 Defined groups > Labor union
    • 7.2 Defined groups > Multiple Employer Trust
    • 7.2 Defined groups > Association
    • 7.2 Defined groups > Credit union
    • 7.3 Marketing considerations
    • 7.3 Marketing considerations > Advertising
    • 7.3 Marketing considerations > Regulatory jurisdiction/place of delivery
    • 7.4 Employer group health insurance
    • 7.4 Employer group health insurance > Insurer underwriting criteria
    • 7.4 Employer group health insurance > Insurer underwriting criteria > Characteristics of the group
    • 7.4 Employer group health insurance > Insurer underwriting criteria > Plan design factors
    • 7.4 Employer group health insurance > Insurer underwriting criteria > Persistency factors
    • 7.4 Employer group health insurance > Insurer underwriting criteria > Administrative capability
    • 7.4 Employer group health insurance > Eligibility for insurance
    • 7.4 Employer group health insurance > Eligibility for insurance > Annual open enrollment
    • 7.4 Employer group health insurance > Eligibility for insurance > Employee eligibility
    • 7.4 Employer group health insurance > Eligibility for insurance > Dependent eligibility
    • 7.4 Employer group health insurance > Coordination of benefits provision
    • 7.4 Employer group health insurance > Change of insurance companies or loss of coverage
    • 7.4 Employer group health insurance > Change of insurance companies or loss of coverage > Coinsurance and deductible carryover
    • 7.4 Employer group health insurance > Change of insurance companies or loss of coverage > No-loss no-gain
    • 7.4 Employer group health insurance > Change of insurance companies or loss of coverage > Events that terminate coverage
    • 7.4 Employer group health insurance > Change of insurance companies or loss of coverage > Reinstatement of Coverage for Military Personnel
    • 7.4 Employer group health insurance > Change of insurance companies or loss of coverage > Notification of Medicare Eligibility
    • 7.4 Employer group health insurance > Change of insurance companies or loss of coverage > Reinstatement of coverage for military personnel
    • 7.4 Employer group health insurance > Change of insurance companies or loss of coverage > Notification of Medicare eligibility
    • 7.4 Employer group health insurance > Change of insurance companies or loss of coverage > Extension of benefits
    • 7.4 Employer group health insurance > Change of insurance companies or loss of coverage > Continuation of coverage under COBRA and Maryland specific rules
    • 7.4 Employer group health insurance > Change of insurance companies or loss of coverage > Conversion privilege
    • 7.4 Employer group health insurance > Continuation of Coverage
    • 7.4 Employer group health insurance > Special Enrollment Periods
    • 7.4 Employer group health insurance > Minimizing Adverse Selection
    • 7.5 Small employer medical plans
    • 7.5 Small employer medical plans > Definition of small employer
    • 7.5 Small employer medical plans > Availability of coverage
    • 7.5 Small employer medical plans > Disclosure of coverage provisions
    • 7.5 Small employer medical plans > Enrollment eligibility
    • 7.5 Small employer medical plans > Renewability
  • 8.0 Dental Insurance 1% (1 item)
    • 8.1 Types of dental treatment
    • 8.1 Types of dental treatment > Diagnostic and preventive
    • 8.1 Types of dental treatment > Restorative
    • 8.1 Types of dental treatment > Oral surgery
    • 8.1 Types of dental treatment > Endodontics
    • 8.1 Types of dental treatment > Periodontics
    • 8.1 Types of dental treatment > Prosthodontics
    • 8.1 Types of dental treatment > Orthodontics
    • 8.2 Indemnity plans
    • 8.2 Indemnity plans > Choice of providers
    • 8.2 Indemnity plans > Scheduled versus nonscheduled plans
    • 8.2 Indemnity plans > Benefit categories
    • 8.2 Indemnity plans > Benefit categories > Diagnostic/preventive services
    • 8.2 Indemnity plans > Benefit categories > Basic services
    • 8.2 Indemnity plans > Benefit categories > Major services
    • 8.2 Indemnity plans > Deductibles and coinsurance
    • 8.2 Indemnity plans > Combination plans
    • 8.2 Indemnity plans > Exclusions
    • 8.2 Indemnity plans > Limitations
    • 8.2 Indemnity plans > Predetermination of benefits
    • 8.3 Employer group dental expense
    • 8.3 Employer group dental expense > Integrated deductibles versus stand-alone plans
    • 8.3 Employer group dental expense > Minimizing adverse selection
  • 9.0 Insurance for Senior Citizens and Special Needs Individuals 9% (7 items)
    • 9.1 Medicare
    • 9.1 Medicare > Nature, financing and administration
    • 9.1 Medicare > Part A — Hospital Insurance
    • 9.1 Medicare > Part A — Hospital Insurance > Individual eligibility requirements
    • 9.1 Medicare > Part A — Hospital Insurance > Enrollment
    • 9.1 Medicare > Part A — Hospital Insurance > Coverages and cost-sharing amounts
    • 9.1 Medicare > Part B — Medical Insurance
    • 9.1 Medicare > Part B — Medical Insurance > Individual eligibility requirements
    • 9.1 Medicare > Part B — Medical Insurance > Enrollment
    • 9.1 Medicare > Part B — Medical Insurance > Coverages and cost-sharing amounts
    • 9.1 Medicare > Part B — Medical Insurance > Exclusions
    • 9.1 Medicare > Part B — Medical Insurance > Claims terminology and other key terms
    • 9.1 Medicare > Part C — Medicare Advantage
    • 9.1 Medicare > Part D — Prescription Drug Insurance
    • 9.2 Medicare supplement insurance
    • 9.2 Medicare supplement insurance > Purpose
    • 9.2 Medicare supplement insurance > Open enrollment
    • 9.2 Medicare supplement insurance > Rating of Medicare supplement plans
    • 9.2 Medicare supplement insurance > Rating of Medicare supplement plans > Attained age
    • 9.2 Medicare supplement insurance > Rating of Medicare supplement plans > Issue age
    • 9.2 Medicare supplement insurance > Rating of Medicare supplement plans > Community rated
    • 9.2 Medicare supplement insurance > Standardized Medicare supplement plans
    • 9.2 Medicare supplement insurance > Standardized Medicare supplement plans > Core benefits
    • 9.2 Medicare supplement insurance > Standardized Medicare supplement plans > Additional benefits
    • 9.2 Medicare supplement insurance > Standardized Medicare supplement plans > High deductible plans
    • 9.3 Other options for individuals with Medicare
    • 9.3 Other options for individuals with Medicare > Employer group health plans
    • 9.3 Other options for individuals with Medicare > Employer group health plans > Disabled employees
    • 9.3 Other options for individuals with Medicare > Employer group health plans > Employees with kidney failure
    • 9.3 Other options for individuals with Medicare > Employer group health plans > Individuals age 65 and older
    • 9.3 Other options for individuals with Medicare > Medicaid
    • 9.3 Other options for individuals with Medicare > Medicaid > Eligibility
    • 9.3 Other options for individuals with Medicare > Medicaid > Benefits
    • 9.4 Long-term care (LTC) policies
    • 9.4 Long-term care (LTC) policies > LTC, Medicare and Medicaid compared
    • 9.4 Long-term care (LTC) policies > Eligibility for benefits
    • 9.4 Long-term care (LTC) policies > Levels of care
    • 9.4 Long-term care (LTC) policies > Levels of care > Skilled care
    • 9.4 Long-term care (LTC) policies > Levels of care > Intermediate care
    • 9.4 Long-term care (LTC) policies > Levels of care > Custodial care
    • 9.4 Long-term care (LTC) policies > Levels of care > Home health care
    • 9.4 Long-term care (LTC) policies > Levels of care > Adult day care
    • 9.4 Long-term care (LTC) policies > Levels of care > Respite care
    • 9.4 Long-term care (LTC) policies > Benefit periods
    • 9.4 Long-term care (LTC) policies > Benefit amounts
    • 9.4 Long-term care (LTC) policies > Optional benefits
    • 9.4 Long-term care (LTC) policies > Optional benefits > Inflation Protection
    • 9.4 Long-term care (LTC) policies > Optional benefits > Nonforfeiture
    • 9.4 Long-term care (LTC) policies > Optional benefits > Guarantee of insurability
    • 9.4 Long-term care (LTC) policies > Optional benefits > Return of premium
    • 9.4 Long-term care (LTC) policies > Qualified and Nonqualified
    • 9.4 Long-term care (LTC) policies > Exclusions
    • 9.4 Long-term care (LTC) policies > Underwriting Considerations
    • 9.4 Long-term care (LTC) policies > Partnership
    • 9.4 Long-term care (LTC) policies > Qualified LTC plans
    • 9.4 Long-term care (LTC) policies > Deductibility of premiums for LTC insurance for state income tax purposes
    • 9.4 Long-term care (LTC) policies > Exclusions
    • 9.4 Long-term care (LTC) policies > Underwriting considerations
    • 9.5 Interaction with Other Coverage
    • 9.5 Interaction with Other Coverage > Medicare
    • 9.5 Interaction with Other Coverage > Medicaid
    • 9.5 Interaction with Other Coverage > Medical Insurance
  • 10.0 Federal Tax Considerations for Health Insurance 5% (4 items)
    • 10.1 Personally-owned health insurance
    • 10.1 Personally-owned health insurance > Disability income insurance
    • 10.1 Personally-owned health insurance > Medical expense insurance
    • 10.1 Personally-owned health insurance > Long-term care insurance
    • 10.2 Employer group health insurance
    • 10.2 Employer group health insurance > Disability income (STD, LTD)
    • 10.2 Employer group health insurance > Medical and dental expense
    • 10.2 Employer group health insurance > Long-term care insurance
    • 10.2 Employer group health insurance > Accidental death and dismemberment
    • 10.3 Medical expense coverage for sole proprietors and partners
    • 10.4 Business disability insurance
    • 10.4 Business disability insurance > Key person disability income
    • 10.4 Business disability insurance > Business overhead expense
    • 10.4 Business disability insurance > Business Disability Buyout
    • 10.5 Health Savings Accounts (HSAs), Health Reimbursement Accounts (HRAs), and Flexible Spending Accounts (FSAs)
    • 10.5 Health Savings Accounts (HSAs), Health Reimbursement Accounts (HRAs), and Flexible Spending Accounts (FSAs) > Health Savings Accounts
    • 10.5 Health Savings Accounts (HSAs), Health Reimbursement Accounts (HRAs), and Flexible Spending Accounts (FSAs) > Health Reimbursement Accounts
    • 10.5 Health Savings Accounts (HSAs), Health Reimbursement Accounts (HRAs), and Flexible Spending Accounts (FSAs) > Flexible Spending Accounts
    • 10.5 Health Savings Accounts (HSAs), Health Reimbursement Accounts (HRAs), and Flexible Spending Accounts (FSAs) > High Deductible Health Plans

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