8 - Maryland Laws and Rules Pertinent to Insurance Latest Update Graded A+

8 - Maryland Laws and Rules Pertinent to Insurance Latest Update Graded A+ An employer MUST have how many employees for a terminated employee to be eligible for COBRA? 20 The act of using misrepresentation to induce an insured person to terminate an existing policy and purchase a new policy is referred to as Twisting Which of the following basics is a producer's fiduciary responsibility? Collecting premiums and paying them to the insurance company A producer who is licensed in Maryland but resident in another state is called a nonresident producer If a producer has been engaged in an administrative action by any governmental agency, within how many days following the final deposition must the producer report the action to the Commissioner? 30 A Maryland insurance producer solicits a life insurance policy. In the event of a controversy between the insured and the company, the producer is considered to represent the company When a producer is replacing an existing ordinary life insurance policy, the producer must take all of the following actions EXCEPT obtain the beneficiary's signature on a summary of all policies to be replaced The Commissioner can deny or refuse a license for an insurance producer if the applicant has done any of the following EXCEPT unintentionally misrepresented a material fact in an application An order from the Commissioner MUST include all of the following EXCEPT the signature of the Governor To provide the funds necessary to carry out the powers and duties of the Life and Health Guaranty Corporation, the Board of Directors shall assess member insurers All of the following are considered to be fraud EXCEPT In order to solicit insurance, an individual MUST achieve all of the following EXCEPT 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 an appointment How are health plans classified according to the Affordable Care Act? Health plans purchased before which date are grandfathered and do not have to follow the ACA's rules and regulations? Health plans purchased before which date are grandfathered and do not have to follow the ACA's rules and regulations? March 23, 2010 Which license is REQUIRED in order to solicit Long Term Care insurance in the State of Maryland? Health Insurance Producer License Beginning January 1, 2014, which of the following factors are acceptable in the rating of small group health insurance? Tobacco use At the option of the insurer, a separate converted policy may be issued to cover a dependent A nonprofit health service plan may NOT issue a contract that covers which of the following types of benefits Disability income benefits The Maryland Health Insurance Plan is designed to provide comprehensive health benefits for medically uninsurable Maryland residents Where on the policy form should individual long-term care insurance policies contain an appropriate captioned renewability provision? On the first page The prescription of a drug for a treatment other than those treatments stated in the labeling approved by the Federal Food and Drug Administration is known as off-label use In the health insurance policy, when should the written notice of claim be given to the insurer? Within 20 days after the occurrence or commencement of any loss covered by the policy After the date of marriage, an insurer is REQUIRED to provide what MINIMUM period of time for an employee to add a new spouse to a small group health plan? 60 days A SHOP Exchange Navigator may seek to replace a health benefit plan already offered by a small employer if the small employer is eligible for a Federal tax credit available only through the SHOP Exchange An insurer may NOT issue which type of contract? An HMO contract An insurance producer is BEST defined as a person who has a contract with an insurance company to represent it A person who, for a fee, gives advice or recommendations on benefits provided by an insurance contract is called an advisor Replacing an existing life insurance policy with a new one may result in a surrender charge A policy of life insurance may NOT be delivered unless the policy has a legible and brief description of the policy on the first page An insurer, in general business practice, fails to promptly provide a reasonable explanation for the denial of a claim. This is considered to be unfair claim settlement practice Which of the following is a TRUE statement regarding the Maryland Insurance Commissioner? The Commissioner shall counsel and advise the Governor on all matters assigned to the Maryland Insurance Administration The Commissioner shall counsel and advise the Governor on all matters assigned to the Maryland Insurance Administration remain in effect until the Insurance Commissioner issues a new one Someone who sells, solicits, or negotiates insurance contracts for compensation is called an insurance producer After completing an application for insurance, the insurance producer collects the premiums but deposits the check in the insurance producer's checking account. What crime has been committed? Fraud An employer may qualify for health care tax credits through SHOP Marketplace if that employer has fewer than how many employees? 25 An employer may qualify for health care tax credits through SHOP Marketplace if that employer has fewer than how many employees? at least the standard plan Fran is currently uninsured. Which of the following would allow Fran to qualify for a special enrollment in his small employer's health benefit plan? Adoption of a child All advertisements for health insurance shall make clear the identity of the insurer i the Secretary of the Department of Health and Mental Hygien The Commissioner must examine the financial affairs of each admitted insurer operating in Maryland at least once every how many years? 1 5 A producer who sells an individual life insurance policy in Maryland MUST deliver to the policyowner A Policy Summary and Buyer's Guide In order to qualify for a company convention, an insurance producer agrees to pay the first quarterly premium for the applicant for new insurance. This is called a The life insurance buyer's guide includes information about all of the following take civil action against an insurer When must a claim on a life insurance policy be paid after proof of loss has been received by the insurer? Promptly One or more necessary or appropriate diagnostic, preventive, therapeutic, rehabilitative, maintenance, or personal care services in a setting other than an acute care unit of a hospital is provided by A group policy may be issued to a labor union. The members eligible for insurance under the policy shall be The purpose of the Life and Health Insurance Guaranty Association is to ensure that claims filed against insolvent insurance companies will be paid