Accident-and-Health-or-Sickness-Producer練習問題集で検証済みで更新された92問題あります
更新されたAccident-and-Health-or-Sickness-Producer試験問題集でPDF問題とテストエンジン
質問 # 52
Misrepresenting pertinent policy provisions relating to coverages after a loss is:
- A. A concealment in insurance applications
- B. A violation of the principle of adhesion
- C. An unfair discrimination between individuals
- D. An unfair claim settlement practice
正解：D
解説：
Misrepresenting coverage post-loss (Insurance Article, § 27-303) is an unfair claims practice, deceiving claimants about benefits. Concealment applies pre-policy, discrimination involves unequal treatment, and adhesion relates to contract terms, not claims.
References:Maryland Insurance Article, § 27-303; MIA claims practices.
質問 # 53
Which statement is true of trade association groups eligible for group medical benefits?
- A. Employer contributions are usually waived
- B. Such associations are formed for the purpose of purchasing insurance
- C. The association membership primarily consists of large employers
- D. Members of the association are usually in the same industry
正解：D
解説：
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.
質問 # 54
In Maryland, a group accident and health certificate of insurance must contain:
- A. A summary of policy features and benefits
- B. A copy of the group contract
- C. A list of all participating physicians
- D. The insurer's financial statement
正解：A
解説：
Certificates (Insurance Article, § 15-1207) summarize policy features and benefits for group members, not the full contract, physician lists, or financial statements, which are separate or irrelevant. This ensures employees understand their coverage.
References:Maryland Insurance Article, § 15-1207; MIA group insurance rules.
質問 # 55
An insurance producer's license may be suspended or revoked by:
- A. The Attorney General
- B. The continuing education course provider
- C. The Maryland Insurance Administration
- D. The appointing insurer
正解：C
解説：
Comprehensive and Detailed Step by Step Explanation:The Maryland Insurance Administration (MIA) has sole authority to regulate, suspend, or revoke an insurance producer's license for violations of state insurance laws:
Maryland Insurance Administration (C):Correct. The MIA oversees producer licensing, compliance, and disciplinary actions.
Appointing insurer (A):Can terminate an appointment but cannot revoke a license.
Continuing education provider (B):Only offers training and has no regulatory authority.
Attorney General (D):Handles legal actions but does not directly manage licensing.
References:Maryland Insurance Article §10-126, Producer Regulation Guidelines, COMAR 31.03.13.
質問 # 56
An insurance producer or advisor in the State of Maryland can be disciplined by the MarylandInsurance Administration for all of the following EXCEPT:
- A. Filing a complaint on behalf of the consumer with the Maryland Insurance Administration
- B. Making a misleading statement about the financial condition of an insurer
- C. Making false or misleading statements about dividends previously paid on similar policies
- D. Using inappropriate description of a policy to hide the true nature of the policy
正解：A
解説：
The MIA (Insurance Article, § 10-126) disciplines producers for misrepresentation (§ 27-202, § 27-503), but filing a consumer complaint with the MIA is a legitimate advocacy action, not a disciplinary offense. It supports consumer protection, unlike the other deceptive practices.
References:Maryland Insurance Article, § 10-126, § 27-202, § 27-503; MIA producer regulations.
質問 # 57
When a single major medical contract covers all medical expenses, the plan is considered to be:
- A. Limited
- B. Comprehensive
- C. First-dollar
- D. Supplemental
正解：B
解説：
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.
質問 # 58
Which feature in a long-term care insurance policy is designed specifically to provide benefits at times when family members need a break from caring for the insured?
- A. Skilled nursing facility care
- B. Home health care
- C. Custodial facility care
- D. Respite care
正解：D
解説：
Respite care (Insurance Article, § 18-101) offers temporary professional care to relieve family caregivers, a mandated feature in Maryland long-term care policies. Skilled nursing, custodial care, and home health care serve ongoing needs, not specifically caregiver breaks.
References:Maryland Insurance Article, § 18-101 et seq.; MIA LTC guidelines.
質問 # 59
Before issuing a policy of long-term care insurance to an applicant who is at least 80 years old, unless the policy is guaranteed issue, the carrier shall obtain a:
- A. Power of attorney
- B. Applicant's family's consent
- C. Report of a physical examination
- D. Copy of the person's living will
正解：C
解説：
For non-guaranteed issue long-term care policies (Insurance Article, § 18-107), a physical exam report is required for applicants 80+ to assess risk, not family consent, living wills, or power of attorney.
References:Maryland Insurance Article, § 18-107; MIA LTC underwriting rules.
質問 # 60
Reasonable and customary charges for health care are based primarily on:
- A. National physician surveys
- B. Average charges within a geographic area
- C. Actuarial tables
- D. Insurance industry studies
正解：B
解説：
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.
質問 # 61
In HMO coverage, all of the following services must be available 24 hours per day, 7 days per week EXCEPT:
- A. Emergency medical care
- B. In-patient hospital services
- C. Primary care
- D. Dental care
正解：D
解説：
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.
質問 # 62
The waiver of premium provision in a disability income policy provides that premiums will be waived during:
- A. The grace period
- B. The time limit on certain defenses
- C. The elimination period
- D. The disability benefit period
正解：D
解説：
The waiver of premium provision (Insurance Article, § 15-201) waives premiums during the disability benefit period-when benefits are paid-easing financial strain. The elimination period requires premium payment, the grace period is for late payments, and the time limit on defenses relates to incontestability, not waivers.
References:Maryland Insurance Article, § 15-201; MIA disability insurance standards.
質問 # 63
Under federal law, an insurance producer may be sentenced to prison for:
- A. Suing an insurer over contract violations
- B. Selling insurance with a nonresident license
- C. Inducing a client to sign an application for insurance
- D. Embezzling money from an insurance company
正解：D
解説：
Federal law (18 U.S.C. § 1033) criminalizes embezzlement by a producer, a felony punishable by prison if interstate commerce is affected. Nonresident licensing is a state issue, inducing applications is legal, and suing is a civil action, not criminal.
References:18 U.S.C. § 1033; MIA producer conduct alignment.
質問 # 64
Who has the right to change the beneficiary of an accident and health policy with a revocable beneficiary designation?
- A. The producer
- B. The beneficiary
- C. The insurer
- D. The policyowner
正解：D
解説：
With a revocable beneficiary (Insurance Article, § 16-201), the policyowner retains the right to change the beneficiary, not the beneficiary, insurer, or producer, who lack such authority.
References:Maryland Insurance Article, § 16-201; MIA policy ownership rules.
質問 # 65
Medical charges that fall within the range of fees normally charged for a given procedure in a certain geographical area are called:
- A. Reasonable and customary charges
- B. Preapproved charges
- C. Utilization charges
- D. Scheduled charges
正解：A
解説：
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.
質問 # 66
When the employer pays the premium, covered individuals normally receive tax-free benefits under all of the following group health plans EXCEPT:
- A. Major medical
- B. Dental
- C. Disability income
- D. Health maintenance organization
正解：C
解説：
Federal tax rules (IRC § 105, § 106) make employer-paid medical benefits (major medical, dental, HMO) tax- free, but disability income benefits are taxable if employer-funded, as they replace income.
References:IRC § 105, § 106; Maryland Insurance Article, § 15-1201; MIA tax guidelines.
質問 # 67
It is unlawful for a person to provide an advertisement that:
- A. Points out coverage advantages of a policy
- B. Makes a comparison of benefits between policies
- C. Refers to the insurer's financial rating
- D. Uses a policy title to misrepresent a coverage
正解：D
解説：
Advertisements (Insurance Article, § 27-503) can highlight advantages or ratings if true, but misrepresenting coverage via a title is illegal, deceiving consumers about policy benefits.
References:Maryland Insurance Article, § 27-503; MIA advertising standards.
質問 # 68
All of the following are characteristics of a preferred risk applicant for disability income insurance EXCEPT:
- A. High income
- B. Non-smoker
- C. Physically active
- D. Non-hazardous occupation
正解：A
解説：
Preferred risk applicants (Insurance Article, § 15-201) have low disability risk due to non-smoking, safe jobs, and physical activity. High income affects benefit amounts, not risk classification, making it the exception.
References:Maryland Insurance Article, § 15-201; MIA underwriting standards.
質問 # 69
If an employer with 200 employees wants to offer health insurance and calls a SHOP Exchange Navigator, what should the navigator do?
- A. Refer the employer to the Maryland Insurance Administration
- B. Refer the employer to the carrier where a friend works
- C. Help the employer sign-up through the SHOP Exchange
- D. Refer the employer to a licensed insurance producer
正解：D
解説：
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.
質問 # 70
If an individual's occupation is considered to be illegal:
- A. It may require a waiver on a disability income insurance policy
- B. It may result in a denial of a disability income claim
- C. It results in a substandard rating on an accident and health insurance policy
- D. It must be stated as such on an accident and health insurance application
正解：B
解説：
Illegal occupations (Insurance Article, § 12-101) can lead to claim denials if disability arises from illegal acts, per public policy. Disclosure isn't mandated, waivers don't apply, and ratings adjust risk, not legality.
References:Maryland Insurance Article, § 12-101; MIA claims policies.
質問 # 71
A health maintenance organization (HMO) must provide coverage for all of the following EXCEPT:
- A. Well-baby or well-child care
- B. Emergency services
- C. Dental and vision care
- D. Routine physical examinations
正解：C
解説：
Maryland HMOs (Health-General Article, § 19-701) must provide basic health services like routine physicals, well-child care, and emergency services. Dental and vision care, however, are not required unless specified as supplemental benefits. State law mandates pediatric care but excludes routine dental and vision from standard HMO coverage unless the plan explicitly includes them.
References:Maryland Health-General Article, § 19-701; Insurance Article, § 15-1201; MIA HMO guidelines.
質問 # 72
......
最新（2025)Maryland Insurance Administration Accident-and-Health-or-Sickness-Producer試験問題集：https://www.jpntest.com/shiken/Accident-and-Health-or-Sickness-Producer-mondaishu
最適な練習法にはMaryland Insurance Administration Accident-and-Health-or-Sickness-Producer試験の素晴らしいAccident-and-Health-or-Sickness-Producer試験問題PDF：https://drive.google.com/open?id=1pNU4ovaTLGLJ7hmnkVCiShkN-J2mtjsE