- MD L&A/H is Maryland's Life and Accident & Health or Sickness Producer Combo Exam, Series 20-30, run through Prometric.
- The exam has 130 scored questions plus 10 unscored pilot items, a 2-hour 30-minute limit, and a 70% passing score.
- Insurance Regulation is the single biggest domain at 30% of the exam.
- As of October 1, 2024, Maryland dropped the prelicensing course requirement before you can sit for the exam.
What Is the MD L&A/H, Exactly?
The MD L&A/H - formally the Maryland Life and Accident and Health or Sickness Producer - Combo Exam (Series 20-30) - is the state licensing exam candidates must pass before they can sell life insurance, annuities, and health/accident products in Maryland. It is governed by the Maryland Insurance Administration and delivered through Prometric testing centers, with an option to test remotely through ProProctor.
This is not a voluntary industry certification or a designation you add to a resume for prestige points. It is the legal gateway to holding a resident insurance producer license covering both the life/annuity line and the accident & health/sickness line in one combined exam, rather than requiring two separate sittings.
If you're still untangling the terminology, our companion pieces on MD L&A/H Meaning and What Does MD L&A/H Stand For? walk through the acronym in more depth.
Who Needs This License
Anyone who wants to be compensated for selling, soliciting, or negotiating life insurance, annuities, or health/accident and sickness insurance products in Maryland needs to hold this producer license. That typically includes:
- New agents joining a captive or independent life and health agency
- Financial services professionals adding insurance products to their offerings
- Career changers entering insurance sales from other industries
- Existing producers in other states seeking Maryland resident or non-resident authority
For a full rundown of eligibility rules and prerequisites, see MD L&A/H Requirements 2026: Eligibility, Prerequisites & How to Qualify.
Exam Format and Mechanics
The exam itself is a multiple-choice test administered on computer. Here's what the format looks like in practice:
- 130 scored questions covering the 16 content domains
- 10 additional unscored (pilot) questions mixed in, which candidates cannot distinguish from scored items
- 2 hours and 30 minutes to complete the full exam
- 70% passing score required
- Immediate results delivered at the test center or through ProProctor
Because unscored items are indistinguishable from scored ones, the practical strategy is to treat every question on screen as if it counts. There's no way to skip questions you suspect are "just pilot items" without risking your actual score. For a deeper breakdown of what makes this test challenging in practice, read How Hard Is the MD L&A/H Exam? Complete Difficulty Guide 2026.
Key Takeaway
Pace yourself against 140 total questions in 150 minutes - roughly a minute per question - while knowing only 130 of them actually affect your score.
The 16 Domains You're Tested On
The MD L&A/H exam blueprint splits content across sixteen domains, weighted very unevenly. Understanding the weighting is the single most important strategic move a candidate can make before opening a textbook.
Domain 1: Insurance Regulation (30%)
By far the largest domain, covering Maryland-specific licensing rules, producer duties, unfair trade practices, and administrative code. This is the domain that decides most pass/fail outcomes.
- Producer licensing and appointment rules
- Unfair claims and trade practices
- Maryland Insurance Administration authority
| Domain | Weight |
|---|---|
| 1. Insurance Regulation | 30% |
| 2. General Insurance | 5% |
| 3. Life Insurance Basics | 9% |
| 4. Life Insurance Policies | 5% |
| 5. Life Insurance Policy Provisions, Options and Riders | 8% |
| 6. Annuities | 5% |
| 7. Federal Tax Considerations for Life Insurance and Annuities | 4% |
| 8. Qualified Plans | 2% |
| 9. Health Insurance Basics | 7% |
| 10. Individual Health Insurance Policy General Provisions | 2% |
| 11. Disability Income and Related Insurance | 5% |
| 12. Medical Plans | 8% |
| 13. Group Health Insurance | 2% |
| 14. Dental Insurance | 1% |
| 15. Insurance for Senior Citizens and Special Needs Individuals | 5% |
| 16. Federal Tax Considerations for Health Insurance | 2% |
Notice that Domains 1, 3, 5, and 12 together account for over half the exam. Life Insurance Basics (9%) and Medical Plans (8%) are the second and third heaviest domains after Regulation, followed closely by Life Insurance Policy Provisions, Options and Riders (8%). Meanwhile, Dental Insurance sits at just 1% - worth knowing, but not worth days of study time.
Domain 3: Life Insurance Basics (9%)
Covers fundamental life insurance concepts - term vs. permanent structures, underwriting basics, and policy ownership concepts that later domains build on.
- Types of life insurance products
- Underwriting and risk classification
- Beneficiary designations
Domain 12: Medical Plans (8%)
Focuses on managed care structures, major medical concepts, and the plan types candidates will encounter when selling health products.
- HMO, PPO, and POS plan structures
- Cost-sharing mechanics (deductibles, copays, coinsurance)
- Managed care provisions
For an exhaustive walk-through of every domain with sample scenarios, see MD L&A/H Exam Domains 2026: Complete Guide to All 16 Content Areas.
Registration, Fees, and Scheduling
Registering for the MD L&A/H involves a few concrete steps and costs that candidates should budget around:
- Exam fee: $62, paid to Prometric when scheduling
- Testing options: in person at a Prometric test center, or remotely via ProProctor
- Prelicensing education: as of October 1, 2024, Maryland no longer requires completion of a Commissioner-approved prelicensing course before sitting for the exam
- Retake waiting period: four days after a failed attempt before you can retest
- Results: delivered immediately after you finish the exam
Because the fee structure and format are simple compared to other producer exams, most of the real "cost" of getting licensed is time spent studying, not money spent on fees. For a full cost breakdown including retake economics, see MD L&A/H Certification Cost 2026: Complete Pricing Breakdown, and for the exact scoring threshold, check MD L&A/H Passing Score 2026: Exactly What You Need to Pass.
Scheduling logistics - including how far in advance to book and what to expect on test day - are covered in MD L&A/H Exam Dates 2026: Testing Windows, Deadlines & Scheduling.
Building a Domain-Weighted Study Plan
Because Insurance Regulation alone carries 30% of the exam, an effective study plan allocates time proportionally rather than spending equal hours on every domain. A simple weighted approach:
Insurance Regulation Foundation
- Study Maryland-specific licensing and producer conduct rules
- Review unfair trade practices and administrative provisions
- This single domain justifies its own week given its 30% weight
Life Insurance Cluster
- Cover Life Insurance Basics, Life Insurance Policies, and Policy Provisions/Options/Riders together
- These three domains combine for 22% of the exam
Health and Medical Plans
- Work through Health Insurance Basics, Medical Plans, and Disability Income
- Together these represent 20% of scored questions
Remaining Domains and Full Review
- Cover Annuities, Qualified Plans, Group Health, Dental, Senior/Special Needs coverage, and both federal tax domains
- Run full-length timed practice exams to simulate the 150-minute format
This kind of weighted scheduling - rather than a flat "read every chapter equally" approach - is the difference between studying efficiently and studying broadly. For a step-by-step guide built entirely around this weighting logic, see MD L&A/H Study Guide 2026: How to Pass on Your First Attempt. You can also run timed, domain-tagged practice questions on our practice test platform to see exactly where your weak spots sit relative to the actual blueprint.
Key Takeaway
Spend roughly a third of your total study time on Insurance Regulation alone - it's worth more than Domains 6 through 16 combined.
What Happens After You Pass
Passing the exam is one part of getting licensed - Maryland also expects producers to maintain the license through ongoing education. Resident producers generally complete 24 continuing education hours per biennium, including 3 ethics hours. This CE requirement keeps producers current on regulatory changes and product developments long after the initial exam is behind them.
If you're weighing whether the licensing process and ongoing CE commitment are worth it relative to the career opportunities it opens, our analysis in Is the MD L&A/H Certification Worth It? Complete ROI Analysis 2026 lays out the tradeoffs without relying on invented numbers.
Careers This License Opens Up
Holding an active MD L&A/H producer license is the baseline requirement for roles such as:
- Life insurance agent at a captive or independent agency
- Health and accident insurance producer
- Annuity sales specialist within a financial services firm
- Combined life/health producer at a multi-line insurance agency
Because the exam covers both life/annuity and health/accident content in one sitting, license holders are qualified to work across a wider range of insurance sales roles than someone who only holds a single-line license. For a closer look at what employers are actually looking for and how roles differ, see MD L&A/H Jobs and MD L&A/H Salary Guide 2026: Complete Earnings Analysis.
New producers preparing for their first agency role often benefit from structured training beyond exam prep alone - see MD L&A/H Training for what that typically involves.
Frequently Asked Questions
No. As of October 1, 2024, Maryland removed the requirement to complete a Commissioner-approved prelicensing program before sitting for the producer exam.
The exam includes 130 scored multiple-choice questions plus 10 unscored items, for 140 total questions, with a 2-hour 30-minute time limit.
You need a 70% passing score on the scored portion of the exam.
Maryland requires a four-day waiting period after a failed attempt before you can schedule a retake through Prometric.
Yes. Candidates can test either in person at a Prometric test center or remotely through ProProctor, and receive results immediately either way.
Want to see where you'd stand against the actual domain weighting today? Try a set of practice questions on MD L&A/H Exam Prep before locking in your study schedule, and browse the MD L&A/H Cheat Sheet 2026: One-Page Review of Must-Know Facts for a fast final review closer to test day.