Maryland Life and Health Insurance Exam: Complete Guide

Maryland's Life and Health insurance exams are Prometric-administered tests available as separate 80-question exams ($60 each, ~105 minutes each) or as the combined Life, Accident & Health exam (130 questions, $60, ~150 minutes). Both formats use Maryland's one-part exam structure since October 2021 — national and state content are interleaved throughout rather than in separate sections. The state portion covers MIA Commissioner authority, Maryland Insurance Article provisions, Maryland Health Connection (MD's state ACA exchange), Maryland's expanded Medicaid, the contributory negligence standard (any fault = complete bar — same as Virginia), and Maryland's distinctive Chesapeake Bay and federal professional market context. Maryland eliminated PLE in October 2024 — making this the first mandatory step for all candidates. Here's the complete guide.

Exam Format and Specs

Combined exam strategy: At $60 for either a single or combined exam, the combined L&H (130 questions) is the most efficient path for candidates pursuing both lines — saves $60 and one exam sitting.

Retakes: Unlimited; 4-day wait; can resit failed part only within 6 months.

Results: Score on screen immediately; email report from Prometric.

Life Exam Content (80 Questions)

National/General Content (~60 questions):

Types of Policies (~12 questions):

Whole life; term life; universal life (traditional, indexed, variable)

Annuities (fixed, variable, indexed; immediate vs. deferred)

Survivorship; combination products

Policy Provisions, Options, and Riders (~15 questions):

Grace period; reinstatement; incontestability; misstatement of age

Non-forfeiture options; settlement options

Riders (waiver of premium, AD&B, guaranteed insurability)

Common exclusions

Field Underwriting Procedures (~9 questions):

Application completion; initial premium; policy delivery

Replacement documentation; insurable interest

Tax Considerations and Qualified Plans (~12 questions):

Tax treatment of premiums/death benefits; MEC; 1035 exchanges

IRAs, 401(k), 403(b); ERISA; viatical settlements

General Insurance Concepts (~12 questions):

Insurable interest; indemnity; subrogation; utmost good faith

Types of insurers; contract law; reinsurance

Maryland State Section (~20 questions, interleaved throughout):

State Regulatory Jurisdiction (4 items):

MIA — dedicated insurance regulator (not a multi-sector agency like VA's SCC, NJ's DOBI, or MN's DOC)

Commissioner Marie L. Grant; authority under Maryland Insurance Article

200 St. Paul Place, Suite 2700, Baltimore, MD 21202; (410) 468-2411

State Regulation (6 items):

Maryland Insurance Article provisions

Producer licensing: no PLE (eliminated Oct 1, 2024); Prometric exam; $60; 70%; 6-month validity; 4-day retake wait; $54 NIPR application; no fingerprinting; 7-10 business day processing; renewal 2 years/last day birth month/$69; CE 24 hrs/3 Ethics/no carryover

Appointment requirements: Maryland does NOT require insurer appointment reporting to MIA (except terminations for cause); insurers maintain Producer Register

ITIN accepted (in addition to SSN, FEIN)

MIA active enforcement: civil penalties up to $5,000 per violation for licensed producers (increased from $500 effective October 1, 2024)

Life-specific state requirements (3 items):

MIA Life insurance policy provisions (free-look; replacement regulations under MD Insurance Article)

Annuity training requirements (before selling annuities; MIA-approved course)

15-month temporary Life license availability

Accident & Health Exam Content (80 Questions)

National Content (~60 questions):

Health insurance plan types (HMO, PPO, POS, EPO)

Disability income (STD/LTD; elimination periods; own-occ vs. any-occ)

Medicare Parts A, B, C (Advantage), D; Medicare Supplement plans A-N

LTC insurance provisions; benefit triggers

ACA provisions; SEP triggers; metal tiers

COBRA and continuation

HIPAA; managed care; group health

Maryland State Section (~20 questions):

Common state content (same regulatory jurisdiction items as Life exam)

A&H-specific state items:

Maryland Health Connection (most tested MD A&H state fact): Maryland's state-based ACA marketplace at marylandhealthconnection.gov. Administered by the Maryland Health Benefit Exchange (MHBE). Producers selling through Maryland Health Connection need familiarity with the exchange. MD is NOT a Healthcare.gov state — distinguishing MD from Virginia, Tennessee, and most other states.

Maryland Health Connection 2026 data:

255,612 enrolled for 2026 coverage (up 3% from prior year; record enrollment)

5 insurers for 2026 (Aetna exited end of 2025)

MD state Premium Assistance program expanded in 2026 to all ages at up to 400% FPL

177,000+ enrollees receiving MD state-funded subsidies in early 2026

Average 2026 rate increase: 13.4% (before subsidies)

MD reinsurance waiver through December 2028 helps keep rates lower than most states

Maryland Medicaid: Maryland expanded Medicaid under the ACA. Adults up to 138% FPL qualify. The correct MIA exam terminology is "Maryland Medicaid" — unlike MN's distinctive "Medical Assistance (MA)" branding.

Maryland health insurance mandates: Maryland requires certain "required health insurance benefits" including: elderly benefits, Alzheimer's disease treatment, mental illness treatment, prescription medications, in vitro fertilization, disability benefits from pregnancy/childbirth, breast cancer screenings, hospice care (Md. Code, Insurance §§ 15-300 et seq.).

Maryland individual mandate: Maryland does NOT have its own individual health insurance mandate — no state tax penalty for being uninsured. (Unlike NJ which reinstated a state mandate in 2019.)

LTC (A&H-specific state section):

LTC training required before selling LTC products in MD

LTC tax credits (1 item in state exam content outline) — Maryland has a specific state income tax credit for LTC insurance premiums — a distinctive MD feature

Maryland types of health providers (2 items): State-licensed HMO, PPO, and other managed care organizations operating in Maryland.

Combined L&H Exam Content (130 Questions)

Covers both Life and A&H content interleaved. State section covers all common regulatory content plus both Life-specific and A&H-specific Maryland provisions. At the same $60 fee as a single exam, the combined is the efficient choice for most full-market candidates.

5 Frequently Asked Questions

• Does Maryland use Healthcare.gov or a state exchange? Maryland Health Connection — Maryland's state-based ACA marketplace at marylandhealthconnection.gov. This is a key A&H state section distinction — MD is NOT a Healthcare.gov state. Virginia, Tennessee, and Ohio use Healthcare.gov; Maryland, New Jersey (Get Covered NJ), Minnesota (MNsure), and Colorado (Connect for Health Colorado) all operate state exchanges.
• What is the Maryland LTC tax credit? Maryland offers a state income tax credit for LTC insurance premiums — a specifically Maryland item in the A&H state exam content outline. This makes MD LTC advisory both a product sale AND a tax planning conversation, since clients may qualify for a state tax credit on their LTC premiums. Verify current credit amounts at the Maryland Comptroller's website.
• Does Maryland have a state health insurance mandate? No — Maryland does not have its own individual health insurance mandate or tax penalty for being uninsured. This distinguishes Maryland from New Jersey (which reinstated a state mandate in January 2019). Maryland relies on Maryland Health Connection's enrollment outreach and subsidies to maintain marketplace participation.
• What are the 3 items in the Life-specific state section? From the PSI/Prometric content outline: (1) State Requirements covering Life insurance policy provisions and regulations specific to Maryland; (2) replacement regulations under Maryland Insurance Article; (3) annuity training and temporary Life license provisions. These are specifically MD-law items not covered by national content.
• How many Maryland-specific questions are on the Life exam? Approximately 20 state-specific items are interleaved throughout the 80-question Life exam. This ~25% state content weight is comparable to other Prometric states (Virginia's 11-01 has 28.6% state content; Maryland's individual exams have ~25%). These Maryland-specific questions are where underprepared candidates most commonly underperform.

Prepare for the Maryland Life & Health Exam

Maryland's state section — MIA structure, Maryland Health Connection, LTC tax credits, and October 2024 PLE elimination context — rewards candidates who prepare specifically. JustInsurance's MIA-approved Maryland courses cover the full Prometric content outline.

Enroll today and prepare for the Maryland exam with confidence.