17 Free Maryland Life & Health Practice Questions: Disability Income, Medical Plans, Group and Dental (2026)
How to Use This Disability Income, Medical Plans, Group and Dental Set
This set covers four sections of the Maryland Accident & Health outline: Disability Income and Related Insurance (5.0, 9%, 7 items), Medical Plans (6.0, 14%, 11 items), Group Health Insurance (7.0, 5%, 4 items) and Dental Insurance (8.0, 1%, 1 item). On the Combo these are sections 11.0 to 14.0, at 5%, 8%, 2% and 1%.
The 17 questions include residual disability, cost-of-living and waiver of premium benefits, the rehabilitation benefit, HSAs, a dental schedule, HMO copayments, coordination of benefits, continuation of coverage, group rating, workers' compensation and TRICARE. Each has an answer and an explanation.
Practice Questions 1-6: Disability Benefits, Coordination of Benefits and Dental
These questions cover residual disability, coordination of benefits, a COLA rider, waiver of premium, HSAs and a dental schedule calculation.
Question 1 (Chapter 6)
Under a Maryland group long-term disability (LTD) plan, an employee is approved for benefits after a 180-day elimination period. Six months into receiving LTD benefits, the employee begins working part-time in a sedentary job earning 40% of their pre-disability income. The LTD policy includes a residual disability benefit provision. What is the most likely outcome regarding their LTD benefits?
- A) Benefits stop immediately because the employee is now working.
- B) Benefits remain unchanged at the full amount because the elimination period was already satisfied.
- C) The employee must requalify as totally disabled to continue receiving any benefits.
- D) Benefits are reduced proportionally to the income loss (60% of the full benefit).
Show answer & explanation
Answer: D
A residual disability benefit provision pays a portion of the full benefit when the insured is working but earning less than pre-disability income due to the disability. Here, the employee earns 40% of pre-disability income, indicating a 60% income loss. Thus, benefits are typically reduced proportionally (e.g., 60% of the full LTD benefit). Benefits do not stop solely because the employee is working part-time if residual coverage applies, and requalification is not required under residual provisions.
Question 2 (Chapter 6)
In Maryland, which of the following statements is true regarding the coordination of benefits (COB) provision in a group health plan when an employee is covered under both their own employer's plan and their spouse's employer's plan?
- A) The employee's own employer's plan is always primary, and the spouse's plan is secondary.
- B) The plan that has covered the employee longer is always primary.
- C) The birthday rule determines which plan is primary for dependent children, but for the employee, their own plan is primary.
- D) Plans may coordinate benefits so that the combined payments do not exceed 100% of the allowable expense.
Show answer & explanation
Answer: D
Coordination of benefits ensures that the total payments from all plans do not exceed 100% of the allowable expense for a claim, preventing overpayment or profit from insurance. For the employee, their own employer's plan is typically primary, but this is not absolute in all COB models (e.g., if the employee is also a dependent elsewhere). The birthday rule applies only to dependent children covered under both parents' plans. Option D correctly states the core purpose of COB: to limit combined payments to 100% of allowable expenses.
Question 3 (Chapter 6)
A Maryland resident has an individual disability income policy with a Cost of Living Adjustment (COLA) rider. If the consumer price index (CPI) increases by 3% in a given year, what is the most likely effect on their disability benefit?
- A) The monthly benefit increases by 3%.
- B) The monthly benefit remains unchanged; the COLA only applies to premiums.
- C) The elimination period is reduced by 3%.
- D) The benefit period is extended by 3%.
Show answer & explanation
Answer: A
A Cost of Living Adjustment (COLA) rider on a disability income policy increases the monthly benefit amount periodically (usually annually) based on an inflation index such as the Consumer Price Index (CPI). If the CPI increases by 3%, the monthly benefit typically increases by 3% to help maintain purchasing power. The COLA does not affect premiums, elimination periods, or benefit periods.
Question 4 (Chapter 6)
A Maryland resident purchases an individual disability income policy that includes a waiver of premium benefit. After becoming totally disabled and receiving monthly benefits, the insured stops paying premiums. Six months later, the insured recovers and returns to work. What happens to the premium payments?
- A) Premiums are permanently waived for the life of the policy.
- B) The insurer refunds all premiums paid during the disability period.
- C) Waiver of premium continues for a 6-month grace period after recovery.
- D) Premium payments resume immediately upon recovery and return to work.
Show answer & explanation
Answer: D
The waiver of premium benefit only applies while the insured is disabled and receiving benefits. Once the insured recovers and returns to work, the disability ends, and the obligation to pay premiums resumes. There is no automatic refund or extension of the waiver beyond the disability period. Options A, B, and C incorrectly suggest the waiver has permanent, refund, or extended effects.
Question 5 (Chapter 6)
A Maryland resident has a Health Savings Account (HSA) linked to their High Deductible Health Plan (HDHP). They turn 65 and enroll in Medicare. What happens to their HSA?
- A) They can no longer make contributions, but can still use existing funds for qualified medical expenses.
- B) The HSA must be closed, and funds distributed within 30 days.
- C) The HSA automatically converts to a Medicare Medical Savings Account (MSA).
- D) Contribution limits increase to catch up for missed years prior to age 65.
Show answer & explanation
Answer: A
Upon enrolling in Medicare, an individual is no longer eligible to make new contributions to an HSA because Medicare is not an HDHP. However, the existing HSA funds remain available for tax-free use to pay for qualified medical expenses, including Medicare premiums (except Medigap). The HSA does not close, convert, or allow catch-up contributions. Options B, C, and D are incorrect based on federal HSA rules that apply in Maryland.
Question 6 (Chapter 6)
A Maryland resident has a dental indemnity plan that uses a schedule of benefits. They need a crown, which is classified as a major service. The plan's schedule lists a maximum benefit of $300 for a crown. The dentist's actual charge is $800. After applying the plan's 50% coinsurance for major services, what is the resident's out-of-pocket cost?
- A) $500
- B) $100
- C) $200
- D) $600
Show answer & explanation
Answer: A
With a scheduled benefit plan, the plan pays the lesser of the scheduled amount or the coinsurance percentage of the actual charge. The schedule for a crown is $300. The coinsurance payment would be 50% of $800 = $400. Since $300 is less than $400, the plan pays $300. The resident pays the difference: $800 - $300 = $500. Option B incorrectly subtracts the schedule from the coinsurance amount. Option C uses only the schedule. Option D ignores the plan's payment entirely.
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Practice Questions 7-12: HMOs, Waiver, Rehabilitation, COB and Continuation
The next six turn on the HMO gatekeeper, what happens to waived premiums, the rehabilitation benefit, coordination of benefits when a deductible is unmet, continuation of coverage and a standard policy requirement.
Question 7 (Chapter 6)
A Maryland resident is covered by a Health Maintenance Organization (HMO) plan. They need to see a dermatologist for a skin condition. Under the typical HMO structure, what is required for this specialist visit to be covered?
- A) The resident can self-refer to any dermatologist within the HMO's network without prior approval.
- B) The resident must pay the full cost upfront and submit a claim for reimbursement.
- C) The resident must visit an out-of-network dermatologist to receive coverage under the HMO's out-of-area benefits.
- D) The resident must first obtain a referral from their primary care physician (PCP).
Show answer & explanation
Answer: D
A defining feature of most HMO plans is the gatekeeper model, where the primary care physician (PCP) coordinates all care. To see a specialist like a dermatologist, the patient typically needs a referral from their PCP for the visit to be covered. Option A describes an open-access or POS plan feature, not a traditional HMO. Option B is incorrect because HMOs operate on a prepaid basis with copayments, not upfront payment and reimbursement. Option C is incorrect; HMOs generally do not cover out-of-network care except in emergencies, and out-of-area benefits are limited and not the primary way to access specialists.
Question 8 (Chapter 6)
A Maryland resident has an individual disability income policy with a Waiver of Premium benefit. The insured becomes totally disabled and begins receiving monthly benefits. Six months later, the insured recovers and returns to full-time work. What happens to the premium payments that were waived during the disability period?
- A) The waived premiums must be repaid to the insurer in a lump sum upon return to work.
- B) The insured must pay double premiums for six months to recoup the waived amounts.
- C) The policy is automatically terminated, and no further action is required regarding premiums.
- D) The waived premiums are forgiven and do not need to be repaid.
Show answer & explanation
Answer: D
The Waiver of Premium benefit in a disability income policy means that if the insured meets the definition of total disability, the insurer waives (forgives) the premium payments due during the period of disability for which benefits are being paid. These premiums are not a loan; they are forgiven and do not need to be repaid upon recovery and return to work. Options A, B, and C are incorrect: there is no repayment requirement, no double-premium requirement, and the policy does not automatically terminate; it remains in force as long as premiums are paid after recovery.
Question 9 (Chapter 6)
A Maryland resident purchases an individual disability income policy that includes a Rehabilitation Benefit. After a disabling injury, the insured participates in an approved vocational retraining program. How does this benefit typically function under the policy?
- A) The benefit pays a lump sum equal to the total premiums paid into the policy upon enrollment in the program.
- B) The benefit replaces the monthly disability income benefit with a payment equal to 100% of the insured's pre-disability income during the retraining period.
- C) The benefit reimburses the insured for expenses related to the retraining program, such as tuition and books, while disability income benefits continue.
- D) The benefit only applies if the insured is totally disabled and unable to participate in any work-related activity, including retraining.
Show answer & explanation
Answer: C
The Rehabilitation Benefit in an individual disability income policy reimburses the insured for approved expenses incurred during a vocational retraining program, such as tuition, books, and supplies, while the monthly disability income benefit continues to be paid. It does not replace the income benefit (B), pay a lump sum (A), or require total disability preventing any work-related activity (D). This benefit supports the insured's return to work by covering retraining costs.
Question 10 (Chapter 6)
Under Maryland law, which statement is true regarding the coordination of benefits (COB) in a group health plan when the primary plan pays less than 100% of the allowable expense due to a deductible not being met?
- A) The secondary plan pays nothing until the primary plan's deductible is satisfied.
- B) The secondary plan may pay up to 100% of the remaining allowable expense, but the combined payment cannot exceed 100% of the allowable expense.
- C) The secondary plan must pay the exact amount of the primary plan's deductible before paying any benefits.
- D) The secondary plan pays its normal coinsurance percentage on the full allowable expense, regardless of the primary plan's payment.
Show answer & explanation
Answer: B
Standard COB rules allow the secondary plan to cover the remaining allowable expense up to 100% of the total allowable amount, ensuring no overpayment. Option A is incorrect because the secondary plan can pay even if the primary deductible isn't met. Option C incorrectly requires the secondary to pay the deductible amount. Option D would cause overpayment if applied to the full expense.
Question 11 (Chapter 6)
Under Maryland's small-employer continuation-of-coverage law (which parallels federal COBRA for employees of businesses too small to be subject to COBRA itself), how is a terminated employee's right to continue coverage affected if the termination is due to gross misconduct?
- A) Coverage cannot be continued under any circumstances for gross misconduct.
- B) Up to 6 months, matching a federal COBRA rule for gross misconduct.
- C) Up to 18 months, regardless of the reason for termination.
- D) Up to 36 months, because Maryland extends coverage for all terminations.
Show answer & explanation
Answer: A
Maryland's small-employer continuation law parallels federal COBRA in this respect: termination for gross misconduct is not a qualifying event, so no continuation coverage is available under either law. Options B, C, and D incorrectly suggest that some period of continuation coverage is available for a termination due to gross misconduct.
Question 12 (Chapter 6)
Which of the following is a standard requirement in individual disability income insurance policies for benefits to be payable, rather than an optional rider or benefit?
- A) A guaranteed insurability rider
- B) A waiver of premium benefit
- C) A provision stating that benefits are not payable if the disability results from war or act of terrorism
- D) A provision that the insured must be under the care of a physician to receive benefits
Show answer & explanation
Answer: D
Standard individual disability income policies require that the insured be under the ongoing care of a physician in order to receive benefits, which helps confirm the disability and ensures appropriate treatment. A guaranteed insurability (future increase option) rider, a waiver of premium benefit, and a war/terrorism exclusion are all optional riders or exclusions that vary by policy, not universal requirements for benefits to be paid.
Practice Questions 13-17: Group Rating, COB Arithmetic, Copayments and Government Programs
The last five include group underwriting and rating, a coordination of benefits calculation, workers' compensation, the HMO copayment and TRICARE.
Question 13 (Chapter 6)
A Maryland resident enrolled in a High Deductible Health Plan (HDHP) opens a Health Savings Account (HSA). In 2024, the individual has self-only coverage under the HDHP. What is the maximum amount they can contribute to their HSA for the year?
- A) $4,150
- B) $7,300
- C) $8,300
- D) $3,650
Show answer & explanation
Answer: A
For 2024, the IRS maximum HSA contribution limit for individuals with self-only HDHP coverage is $4,150 (the family-coverage limit is $8,300). Options B, C, and D do not reflect the correct 2024 self-only limit -- $3,650 and $7,300 were earlier years' figures, and $8,300 is the family limit, not the self-only limit.
Question 14 (Chapter 6)
A Maryland employer sponsors a self-funded group health plan for its 200 employees. The plan includes a coordination of benefits (COB) provision. An employee is covered under this plan and also under their spouse's fully insured group health plan in Maryland. The employee incurs $5,000 in covered medical expenses. The primary plan pays $3,000. Under standard COB rules applicable in Maryland, what is the maximum the secondary plan will pay?
- A) $5,000
- B) $3,000
- C) $2,000
- D) $0
Show answer & explanation
Answer: C
C is correct. Under standard COB provisions (referenced in outline Section 6.10), the secondary plan pays up to 100% of the remaining allowable expenses after the primary plan pays, but the combined payments cannot exceed 100% of the total allowable expense. Here, $5,000 total allowable - $3,000 primary payment = $2,000 maximum secondary payment. A would exceed 100% of allowable expenses. B equals the primary payment, not the remainder. D would apply only if primary paid 100%.
Question 15 (Chapter 6)
A Maryland construction worker suffers a severe leg injury while working on a job site. The injury prevents them from performing their duties. Which of the following is the primary source of benefits for this worker's medical expenses and lost wages?
- A) Social Security Disability Income (SSDI)
- B) Individual Disability Income policy
- C) Workers' Compensation
- D) Their employer's group health insurance
Show answer & explanation
Answer: C
Workers' Compensation is a state-mandated program that provides benefits to employees for work-related injuries or illnesses, covering medical expenses and lost wages regardless of fault. SSDI is a federal program for long-term disability, with a strict definition of disability and a waiting period. An Individual Disability Income policy covers non-occupational disabilities unless an occupational rider is added. Group health insurance primarily covers non-occupational medical expenses.
Question 16 (Chapter 6)
A Maryland resident is enrolled in a Health Maintenance Organization (HMO) plan. They visit their primary care physician for a routine check-up and pay a small fee at the time of service. This fee is known as a:
- A) Deductible
- B) Coinsurance
- C) Copayment
- D) Premium
Show answer & explanation
Answer: C
A copayment (or copay) is a fixed amount an insured pays for a covered health care service, typically at the time of service. HMOs often use copayments for office visits and other services. A deductible is the amount an insured must pay out-of-pocket before the insurer begins to pay. Coinsurance is a percentage of the cost of a covered health care service that an insured pays after meeting the deductible. A premium is the regular payment made to the insurer to maintain coverage.
Question 17 (Chapter 6)
A Maryland resident is an active-duty service member in the U.S. Army. Which federal healthcare program provides coverage for this individual and their eligible family members?
- A) Medicare
- B) Medicaid
- C) TRICARE
- D) Veterans Health Administration (VA)
Show answer & explanation
Answer: C
TRICARE is the healthcare program for uniformed service members, retirees, and their families worldwide. Medicare is for individuals aged 65 or older, or those with certain disabilities. Medicaid is a state and federal program that provides health coverage to low-income individuals. The Veterans Health Administration (VA) provides healthcare services to eligible veterans.
The Mistakes That Cost Marks
Dropping the arithmetic order. Coordination of benefits and cost-sharing questions have a fixed order. Work out the allowable expense, subtract what the primary plan pays, and the secondary plan pays at most the remainder.
Forgetting the schedule cap. A scheduled dental plan pays the lesser of the schedule and the coinsurance amount.
Treating residual disability as all or nothing. A residual benefit pays in proportion to the income lost, rather than stopping when the insured returns to work part-time.
Misreading waiver of premium. Waived premiums are forgiven, not repaid, and they apply only while the insured is disabled and receiving benefits.
Mixing up the benefits that pay and the benefits that reimburse. A rehabilitation benefit reimburses approved retraining expenses while the income benefit continues.
Naming the wrong copayment term. A fixed fee at the time of service is a copayment. A deductible is paid before the insurer pays, and coinsurance is a percentage.
Sending a work injury to the wrong program. Workers' compensation is the primary source for a work-related injury.
Your Next Step
Missed questions point to the outline section to revisit. When you are ready, preview the Maryland Life & Health course for the audio lessons and the full question bank, or go back to the free Maryland practice question hub for the other topic sets.
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