Life-and-Accident-and-Health-or-Sickness-Producer-Combo問題集で2026年最新のInsurance Licensing Life-and-Accident-and-Health-or-Sickness-Producer-Combo試験問題
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質問 # 146
In general practice, which one of the following is true of the powers of the Maryland Insurance Administration with respect to access to a producer's business records?
- A. The Maryland Insurance Administration has no right to access a producer's business records because of privacy considerations
- B. Authorization must come from the National Association of Insurance Commissioners (NAIC)
- C. Records can only be accessed by an order of a state court
- D. Records must be produced upon the request of the Maryland Insurance Administration
正解：D
解説：
The MIA (Insurance Article, § 2-207) can request and access producer records for audits or investigations, overriding privacy for regulatory purposes. Court orders or NAIC approval aren't required, and access is a standard power.
References:Maryland Insurance Article, § 2-207; MIA regulatory authority.
質問 # 147
Which activity requires an individual to be licensed as an adviser, rather than as a producer?
- A. Charging a fee for contracted insurance advisory services
- B. Giving advice on policy coverages to an insured
- C. Receiving commissions from an insurance company
- D. Binding insurance coverage with licensed insurers
正解：A
解説：
Identify what an "adviser" does vs. what a "producer" does (conceptual distinction).
A producer (agent/broker) is generally licensed to solicit, sell, negotiate, or bind insurance and is typically compensated by commissions paid by insurers.
An insurance adviser/consultant is generally someone who is compensated by a client fee to provide advisory
/consulting services about insurance, rather than acting as the seller/placer of coverage for commission.
Evaluate each option against the adviser-vs-producer role.
A). Giving advice on policy coverages to an insured
Producers commonly explain coverages as part of selling/servicing policies. This is usually within the scope of producer activity.
So, this does not uniquely require an adviser license.
B). Charging a fee for contracted insurance advisory services
Charging a separate advisory fee under a consulting/advisory contract is the hallmark of an insurance adviser
/consultant function (fee-based advice).
Therefore, this activity is the one that points to needing an adviser license rather than a producer license.
C). Receiving commissions from an insurance company
Commissions are the standard compensation model for producers, not advisers.
So, this aligns with a producer license.
D). Binding insurance coverage with licensed insurers
Binding coverage is a classic producer/agent function (authority to place coverage).
So, this aligns with a producer license.
Maryland regulatory context tie-in (why this matters in practice).
Maryland's insurance framework recognizes licensed producer activity (e.g., the regulations define "licensed producer" in COMAR 31.15.07 as a person licensed under Maryland Insurance Article Title 10 Subtitle 1).
While your provided Maryland claims-handling document mainly covers unfair claim settlement practices and claims standards, it still reinforces that Maryland insurance activities are regulated and role-based (e.g., it defines licensed producer and regulates insurer/producer conduct in claims communications).
In a real-world compliance setting, charging a fee for advisory services is treated differently from being paid by insurer commission, which is why "adviser" licensing is associated with fee-based insurance consulting rather than selling/binding policies.
Bottom line.
Only Option B clearly describes the fee-based advisory/consulting activity that requires an adviser (consultant) license rather than a producer license.
質問 # 148
Typically, the premium for an individual mortgage protection life insurance policy:
- A. Increases at ten-year intervals
- B. Fluctuates with the mortgage interest rate
- C. Remains level
- D. Increases at five-year intervals
正解：C
解説：
Purpose of mortgage protection insurance.
Mortgage protection life insurance is designed to:
Pay off or reduce the mortgage balance if the insured dies.
Structure of most mortgage protection policies.
The death benefit typically decreases over time as the mortgage balance declines.
However, the premium usually remains level throughout the policy term.
Why level premiums are used.
Level premiums make budgeting easier for homeowners.
The insurer prices the policy based on average risk over the term.
Evaluate each option.
A). Remains level
Correct.
B). Increases every five years
Describes step-rate term insurance, not typical mortgage protection.
C). Increases every ten years
Not standard for mortgage protection.
D). Fluctuates with interest rate
Incorrect. Insurance premiums are not tied to mortgage interest rates.
Maryland consumer disclosure relevance.
Maryland requires producers to explain decreasing benefits and level premiums to avoid consumer confusion.
Conclusion.
Mortgage protection premiums typically remain level.
質問 # 149
Which of the following reinforces the rule that ambiguities in insurance contracts should be interpreted in favor of the policyholder?
- A. Reasonable expectations
- B. Retention
- C. Representation
- D. Retrocession
正解：A
解説：
The doctrine of reasonable expectations ensures that ambiguities in insurance policies are resolved in favor of the policyholder:
Reasonable expectations (B): Protects policyholders by ensuring contracts are interpreted based on how an average person would understand them, especially when ambiguities exist.
Representation (A): Refers to the accuracy of statements made during application, unrelated to contract interpretation.
Retention (C): Concerns risk management, not contract ambiguities.
Retrocession (D): Deals with reinsurance, not policyholder rights.
References: Maryland Contract Law, Insurance Ambiguities Guidelines, and COMAR 31.15.03.
質問 # 150
In Maryland, an insurance producer is a person who solicits, negotiates, or sells insurance plans PRIMARILY in conjunction with:
- A. Earning commission
- B. Enrolling individuals in group plans
- C. Acting as a regularly salaried officer
- D. Performing clerical duties
正解：A
解説：
A producer (Insurance Article, § 1-101(aa)) solicits and sells insurance primarily for commissions, distinguishing them from clerical staff, enrollment facilitators, or salaried insurer employees. This reflects their independent role.
References:Maryland Insurance Article, § 1-101(aa), § 10-101; MIA producer definitions.
質問 # 151
When an accident and health insurer requires a covered individual to undergo a physical examination, who pays the cost of the examination?
- A. The principal insured individual
- B. The premium payor
- C. The patient or parent of the patient
- D. The insurer
正解：D
解説：
If an insurer mandates a physical exam (Insurance Article, § 12-202), it pays the cost, as it's a condition of coverage or claims processing. The premium payor, insured, or patient isn't responsible for insurer-initiated requirements.
References:Maryland Insurance Article, § 12-202; MIA policy standards.
質問 # 152
The purpose of regulation of insurance advertising is to do all of the following EXCEPT:
- A. Maintain a low profile for insurance products
- B. Prevent unfair competition among insurers
- C. Present an accurate description of insurance to the public
- D. Establish minimum standards of conduct
正解：A
解説：
Purpose of insurance advertising regulation in Maryland.
Maryland regulates insurance advertising to protect consumers from misrepresentation, deception, and unfair trade practices.
Advertising rules are designed to ensure honesty, accuracy, and fair competition.
Evaluate each option.
A). Establish minimum standards of conduct
Correct. Maryland sets minimum advertising standards to ensure ethical practices.
B). Prevent unfair competition among insurers
Correct. Advertising rules prevent insurers from gaining an unfair advantage through misleading claims.
C). Maintain a low profile for insurance products
Incorrect. Regulators do not restrict visibility or promotion of insurance products; they regulate how products are advertised, not whether they are promoted.
D). Present an accurate description of insurance to the public
Correct. Accuracy and clarity are primary goals of Maryland insurance advertising regulation.
Conclusion.
Maintaining a low profile is not a regulatory goal, making option C the correct answer.
質問 # 153
When determining the premiums for large groups, most insurance companies use:
- A. Experience rating
- B. Occupational rating
- C. Area rating
- D. Pooled rating
正解：A
解説：
Large group premiums (Insurance Article, § 15-1205) use experience rating, basing rates on the group's claims history. Occupational rating applies to specific jobs, area rating to geography, and pooled rating to small groups, none of which dominate large groups.
References:Maryland Insurance Article, § 15-1205; MIA group insurance guidelines.
質問 # 154
How many days does a former employee have to convert a group term policy to an individual policy after employment is terminated?
- A. 0
- B. 1
- C. 2
- D. 3
正解：D
解説：
Under Maryland insurance law, a terminated employee has 31 days (D) to convert a group term life insurance policy into an individual policy without providing evidence of insurability.
This grace period allows individuals to maintain coverage while securing individual insurance.
10 (A), 20 (B), or 30 days (C) are incorrect, as Maryland mandates a specific 31-day window.
References: Maryland Conversion Rights in Group Life Insurance Policies, Section 15-401 of the Insurance Article.
質問 # 155
The Maryland State Benchmark Plan applies to which of the following?
- A. Individual Health Benefit Plans sold through the Exchange
- B. Medicare supplement plans sold outside the Exchange prior to January 1, 2014
- C. Medicaid plans sold through the Exchange
- D. Individual Health Benefit Plans sold outside the Exchange prior to January 1, 2014
正解：A
解説：
The Maryland Benchmark Plan (Insurance Article, § 31-115) defines EHBs for individual and small group plans sold via the Maryland Health Connection Exchange, not Medicaid, Medigap, or pre-2014 off-Exchange plans.
References:Maryland Insurance Article, § 31-115; MIA ACA guidelines.
質問 # 156
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 a licensed insurance producer
- C. Help the employer sign-up through the SHOP Exchange
- D. Refer the employer to the carrier where a friend works
正解：B
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 # 157
Which of the following statements about participating life insurance is true?
- A. Policyowners are assessed monthly for losses.
- B. The insurer must be a stock company.
- C. Policyowners may be entitled to receive dividends.
- D. The insured must be the policyowner.
正解：C
解説：
Participating life insurance policies, often issued by mutual companies, include the possibility of dividends:
Dividends (A) represent a share of surplus profits distributed to policyowners.
Policyowners are not assessed for losses (B); the insurer bears those.
The insured and policyowner can be different individuals, making (C) incorrect.
Mutual insurers typically issue participating policies, not stock companies (D).
References: Maryland Insurance Law on Participating Policies.
質問 # 158
Under Maryland law, the agreement between an insurance producer and insurer under which the insurance producer, for compensation, may sell, solicit, or negotiate policies issued by the insurer is defined as:
- A. A license
- B. An appointment
- C. A binding agreement
- D. A certificate of authority
正解：B
解説：
An appointment (Insurance Article, § 10-103) is the formal agreement allowing a producer to sell an insurer's policies for compensation, distinct from a license (producer credential), certificate of authority (insurer's right), or vague binding agreement.
References:Maryland Insurance Article, § 10-103, § 4-101; MIA producer regulations.
質問 # 159
The primary purpose of disability income insurance is to:
- A. Provide indemnity for loss of life
- B. Provide benefit payments for a period of time when the insured is unable to work
- C. Pay any physicians' fees resulting from a disabling injury
- D. Pay necessary hospital expenses when the insured is unable to work
正解：B
解説：
Disability income insurance (Insurance Article, § 15-201) replaces income during disability, not life indemnity, hospital costs (health insurance), or physician fees (medical insurance). It supports financial stability when work is impossible.
References:Maryland Insurance Article, § 15-201; MIA disability insurance standards.
質問 # 160
The time when an insured must be disabled before becoming eligible for disability benefits is the:
- A. Elimination period
- B. Contestability period
- C. Benefit period
- D. Grace period
正解：A
解説：
Comprehensive and Detailed in Depth Explanation:
The correct answer isD. Elimination period. In disability income insurance, the elimination period is the waiting period that must pass after the disability begins and before the insured becomes eligible to receive disability benefits. The NAIC describes the waiting or elimination period as the period connected with when benefits begin after the onset of disability; longer waiting periods generally reduce premiums. Another NAIC disability income reference defines the elimination period as the time between the onset of disability and benefit eligibility.
The benefit period is the length of time disability benefits are payable after they begin. The contestability period is the time during which an insurer may contest certain policy statements. The grace period is extra time allowed to pay a premium without the policy immediately lapsing. Official Reference: NAIC disability insurance guidance on waiting/elimination periods.
質問 # 161
A valid contract requires all of the following EXCEPT:
- A. Competent parties
- B. Offer and acceptance
- C. Written evidence
- D. Consideration
正解：C
解説：
To be legally enforceable, a contract must meet the following requirements:
Offer and acceptance (A): One party must propose terms, and the other must agree to them.
Competent parties (B): Individuals must have the legal capacity to enter a contract (e.g., not minors or mentally incapacitated).
Consideration (C): Each party must provide something of value (e.g., money, services, or promises).
Written evidence (D) is not required for all contracts, as some verbal agreements are enforceable depending on the type of contract (except for specific cases like real estate).
References: Maryland Contract Law Principles.
質問 # 162
All of the following are typical health maintenance organization (HMO) preventive care services provided by a primary care physician EXCEPT:
- A. Physical examinations
- B. Experimental surgery
- C. Immunizations for children
- D. Well-baby checkups
正解：B
解説：
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.
質問 # 163
How does the payment of an accelerated benefit affect a life insurance policy?
- A. It decreases the grace period.
- B. It increases the cash value.
- C. It decreases the death benefit.
- D. It increases the policy premium.
正解：C
質問 # 164
Who has the right to change the beneficiary of an accident and health policy with a revocable beneficiary designation?
- A. The beneficiary
- B. The policyowner
- C. The insurer
- D. The producer
正解：B
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 # 165
Prescription drug plans sometimes control expenses by encouraging the use of:
- A. Brand-name drugs
- B. Generic drugs
- C. Legend drugs
- D. Federally approved drugs
正解：B
解説：
Comprehensive and Detailed in Depth Explanation:
Prescription drug plans commonly control costs by encouraging members to usegeneric drugs. The Maryland Insurance Administration explains that prescription drug coverage often uses aformulary, or list of covered drugs, arranged by tiers. In Maryland's consumer guidance,Tier 1 is generic drugs, and these are described as
"lower-cost drugs," while preferred and non-preferred brand-name drugs are placed in higher tiers and generally cost more. Therefore, the correct answer isC. Generic drugs.
A "legend drug" simply means a drug that generally requires a prescription; it does not specifically identify the lower-cost option. "Federally approved drugs" is too broad because both generic and brand-name drugs may be federally approved. "Brand-name drugs" are usually more expensive than generic drugs, so encouraging brand-name drugs would not typically be the cost-control method tested here. Official Maryland Reference: Maryland Insurance Administration, prescription drug coverage and formulary tiers.
質問 # 166
All of the following are exclusions or restrictions sometimes found in life insurance policies EXCEPT:
- A. Suicide
- B. Aviation
- C. War
- D. Accidental death
正解：D
解説：
Purpose of exclusions in life insurance.
Exclusions limit coverage for high-risk or extraordinary events.
Common life insurance exclusions.
Suicide: Usually excluded during the first two policy years.
Aviation: May exclude non-commercial or private aviation.
War: Often excluded due to catastrophic risk.
Why accidental death is not an exclusion.
Accidental death is a covered cause of death, and often provides enhanced benefits under riders.
Evaluate each option.
A). Suicide - exclusion
B). Accidental death - covered peril
C). Aviation - possible exclusion
D). War - possible exclusion
Maryland policy drafting relevance.
Maryland requires exclusions to be clearly stated and not misleading.
Conclusion.
Accidental death is not an exclusion.
質問 # 167
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