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Massachusetts Health Insurance — Requirements & Free Practice

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Licenses, application pathways and examination requirements

Each license and applicant pathway has its own requirements and exemptions. Choosing practice questions does not determine your eligibility.

Bank, Credit Union and Lender Insurance Producer

Institutional licensing for insurance sales by banks, credit unions and lenders, with sales conducted through licensed producers.

Licensing authority: division of insurance · Application information

Issuance to a federally chartered bank or credit union
No examination is required for this applicant pathway.
Application
Submit the institution's application, plan of operation, required documentation and nonrefundable $75 fee.
Charter
Federally chartered institution.
Federal compliance
Submit a statement of compliance with all federal insurance-sales conditions and the plan directly to the Division of Insurance, including complaint handling and consumer-protection and information safeguards.
License term
Institutional licenses are issued for one year.
Licensed representatives
Sales must be conducted through individually licensed producers; subsidiaries and affiliates must hold independent producer licenses and be identified in the institution's application.
Physical separation
Request any physical-separation waiver from the responsible regulator and submit the approved waiver with the application.

Official no-examination sources

Effective from 2026-09-22.

Issuance to an eligible lender
No examination is required for this applicant pathway.
Application
Submit the institution's application, plan of operation, required documentation and nonrefundable $75 fee.
Lender authorization
Applicant is a lender covered by M.G.L. c. 167F, § 2A(f) and 211 CMR 142.03; obtain applicable Division of Banks approval and submit the approved plan with the institutional producer application.
License term
Institutional licenses are issued for one year.
Licensed representatives
Sales must be conducted through individually licensed producers; subsidiaries and affiliates must hold independent producer licenses and be identified in the institution's application.
Physical separation
Request any physical-separation waiver from the responsible regulator and submit the approved waiver with the application.

Official no-examination sources

Effective from 2026-09-22.

Nonresident issuance to an eligible institution wholly outside Massachusetts
No examination is required for this applicant pathway.
Licensed representatives
Sales and responsible-producer duties require appropriately licensed producers; the institution has no separate licensing examination.
Location
Eligible bank or federal credit union is located wholly outside Massachusetts and authorized under applicable law to conduct insurance sales.
Reciprocity
Meet § 162N(a) home resident-licensure, good-standing, application, fee and reciprocity requirements.

Official no-examination sources

Effective from 2026-09-22.

Amend approved institutional insurance sales activities
No examination is required for this applicant pathway.
Amendment
Use the Division's applicable plan-of-operation amendment form for approved institutional insurance-sales activities; maintain producer licensing and applicable regulatory approvals.

Official no-examination sources

Effective from 2026-09-22.

Annual renewal of an institutional producer license
No examination is required for this applicant pathway.
Application
Submit the institution's application, plan of operation, required documentation and nonrefundable $75 fee.
License term
Institutional licenses are issued for one year.
Licensed representatives
Sales must be conducted through individually licensed producers; subsidiaries and affiliates must hold independent producer licenses and be identified in the institution's application.
Physical separation
Request any physical-separation waiver from the responsible regulator and submit the approved waiver with the application.
Renewal
Renew annually by the date printed on the institutional license; retain all qualifying approvals and licensed sales personnel.

Official no-examination sources

Effective from 2026-09-22.

Issuance to a Massachusetts chartered bank or credit union
No examination is required for this applicant pathway.
Application
Submit the institution's application, plan of operation, required documentation and nonrefundable $75 fee.
Charter
Massachusetts-chartered bank or credit union; an applicable Massachusetts branch falls within the regulation's State Bank definition.
License term
Institutional licenses are issued for one year.
Licensed representatives
Sales must be conducted through individually licensed producers; subsidiaries and affiliates must hold independent producer licenses and be identified in the institution's application.
Physical separation
Request any physical-separation waiver from the responsible regulator and submit the approved waiver with the application.
Plan approval
Obtain Division of Banks approval of the insurance-sales plan before sending it with the application to the Division of Insurance.

Official no-examination sources

Effective from 2026-09-22.

Business Entity Insurance Producer — Accident and Health or Sickness

A business entity licensed as an insurance producer for Accident and Health or Sickness that designates a licensed producer responsible for compliance with Massachusetts insurance laws, rules and regulations.

Licensing authority: Massachusetts Division of Insurance · Application information

Add the health line to a business entity producer license
No examination is required for this applicant pathway.
Application
Use NIPR to update the entity's authorized lines and affiliations; the entity's own qualification remains the § 162L(b) licensed-producer condition.
Line qualification
Maintain at least one affiliated member licensed in Massachusetts for Accident and Health or Sickness; a member can hold all entity lines or several members can collectively cover them.

Official no-examination sources

Effective from 2026-09-22.

Initial reapplication after business entity license expiration
No examination is required for this applicant pathway.
Entity documents
Submit NIPR's uniform business entity application, pay fees, obtain Division name approval, register with the Secretary of the Commonwealth, and provide the required certified registration documents and Massachusetts good-standing letter.
Expired license
An expired entity cannot submit a renewal application; submit a new initial entity application through NIPR.
Prior individual licensing
The DRLP's and members' existing individual licenses are qualifications of the entity; the entity licensing provision in § 162L(b) requires no entity licensing examination.
Responsible producer
Designate at least one Designated Responsible Licensed Producer (DRLP); all affiliated members must hold Massachusetts producer licenses and at least one must hold the Accident and Health or Sickness line.

Official no-examination sources

Effective from 2026-09-22.

Nonresident business entity issuance by reciprocity
No examination is required for this applicant pathway.
Entity documents
Submit NIPR's uniform business entity application, pay fees, obtain Division name approval, register with the Secretary of the Commonwealth, and provide the required certified registration documents and Massachusetts good-standing letter.
Home license
The entity must be resident-licensed in good standing in its home jurisdiction, which must award nonresident licenses to Massachusetts residents on the same basis.
Prior individual licensing
The DRLP's and members' existing individual licenses are qualifications of the entity; the entity licensing provision in § 162L(b) requires no entity licensing examination.
Responsible producer
Designate at least one Designated Responsible Licensed Producer (DRLP); all affiliated members must hold Massachusetts producer licenses and at least one must hold the Accident and Health or Sickness line.

Official no-examination sources

Effective from 2026-09-22.

Timely renewal of a business entity producer license
No examination is required for this applicant pathway.
Renewal
Renew through NIPR before expiration. Massachusetts provides no late-renewal grace period for business entities.
Responsible producers
Maintain licensed DRLPs and affiliated members sufficient for each authorized line.

Official no-examination sources

Effective from 2026-09-22.

Resident business entity issuance
No examination is required for this applicant pathway.
Entity documents
Submit NIPR's uniform business entity application, pay fees, obtain Division name approval, register with the Secretary of the Commonwealth, and provide the required certified registration documents and Massachusetts good-standing letter.
Prior individual licensing
The DRLP's and members' existing individual licenses are qualifications of the entity; the entity licensing provision in § 162L(b) requires no entity licensing examination.
Responsible producer
Designate at least one Designated Responsible Licensed Producer (DRLP); all affiliated members must hold Massachusetts producer licenses and at least one must hold the Accident and Health or Sickness line.

Official no-examination sources

Effective from 2026-09-22.

Fraternal Benefit Society Insurance Agent — Accident and Health

A society-specific agent license under Chapter 176, Section 35, including individuals and qualifying corporations authorized for accident and health contracts.

Licensing authority: Massachusetts Division of Insurance · Application information

Initial issuance to a corporate fraternal society agent
No examination is required for this applicant pathway.
Application
Submit the prescribed application, information and fees and the society's officer-certified assurance of trustworthiness, competence and appointment if licensed.
Corporation
Corporation organized exclusively to act as the society's insurance agent; comply with applicable § 174 requirements, including certified formation documents and statements for persons named in the license.
Named individuals
Individuals seeking to be named as licensees representing the society are expressly exempt from written or other examinations by § 35(4)(c).
Scope
Authorization is limited to the named society and its authorized contracts; this survey addresses accident and health insurance.
Society
Represent a fraternal benefit society authorized to do business in Massachusetts and named in the license.

Official no-examination sources

Effective from 2026-09-22.

Discretionary reinstatement after refusal to renew and hearing request
No examination is required for this applicant pathway.
Fitness
Trustworthiness, competence and licensing prerequisites remain applicable.
Hearing
Request a hearing in writing within 30 days after notice of refusal; the commissioner grants a hearing within a reasonable time and may reinstate the license.

Official no-examination sources

Effective from 2026-09-22.

Initial issuance to an individual fraternal society agent
No examination is required for this applicant pathway.
Application
Submit the prescribed application, information and fees and the society's officer-certified assurance of trustworthiness, competence and appointment if licensed.
Scope
Authorization is limited to the named society and its authorized contracts; this survey addresses accident and health insurance.
Society
Represent a fraternal benefit society authorized to do business in Massachusetts and named in the license.

Official no-examination sources

Effective from 2026-09-22.

Reissuance after the statutory fraternal agent revocation waiting period
No examination is required for this applicant pathway.
Application
Submit the prescribed application, information and fees and the society's officer-certified assurance of trustworthiness, competence and appointment if licensed.
Approval
After the waiting period, issuance remains subject to the commissioner's current trustworthiness, competence and application determinations.
Scope
Authorization is limited to the named society and its authorized contracts; this survey addresses accident and health insurance.
Society
Represent a fraternal benefit society authorized to do business in Massachusetts and named in the license.
Waiting period
No entitlement to a new agent license for one year after revocation, or one year after a final judicial decision affirming the revocation.

Official no-examination sources

Effective from 2026-09-22.

Renewal of a fraternal society agent license
No examination is required for this applicant pathway.
Application
Submit the prescribed application, information and fees and the society's officer-certified assurance of trustworthiness, competence and appointment if licensed.
Expiration
License or renewal expires December 31 of the even-numbered calendar year following the calendar year of issuance.
Renewal application
The society may submit the prescribed renewal application and certificate; the commissioner may require separate agent applications and appointment/fitness certificates.
Scope
Authorization is limited to the named society and its authorized contracts; this survey addresses accident and health insurance.
Society
Represent a fraternal benefit society authorized to do business in Massachusetts and named in the license.
Timely application
An application filed by December 31 permits continued activity under the existing license until renewal issuance or the statutory period after refusal, absent suspension or revocation.

Official no-examination sources

Effective from 2026-09-22.

Insurance Producer — Accident and Health or Sickness

An individual insurance producer license carrying the Accident and Health or Sickness line of authority. Massachusetts issues one individual producer license to which lines are added.

Licensing authority: Massachusetts Division of Insurance · Application information

Restore a producer license suspended for continuing education noncompliance
No examination is required for this applicant pathway.
Compliance
Demonstrate compliance with all CE requirements and all other licensing laws to the commissioner's satisfaction; § 177E(H) suspends the license until this is shown.
Penalties
Applicable hearings and fines remain; CE instruction is an applicant condition.

Official no-examination sources

Effective from 2026-09-22.

Renewal or restoration with military service or extenuating circumstance waiver request
Producer - Accident and Health or Sickness
Commissioner discretion
The producer may also request waiver of any examination requirement or fines or sanctions. The currently offered health examination remains the leaf where the underlying renewal failure requires it; a granted waiver excuses the applicant.
Extenuating circumstance
A licensed producer unable to comply with renewal procedures because of military service or another extenuating circumstance may request waiver of those procedures.
Resident application after the 12 month reinstatement window
Producer - Accident and Health or Sickness
Application
Meet the current resident application and health line requirements.
Lapsed license
The examination-free reinstatement provision in § 162M(c) applies only within 12 months. A later resident application follows § 162K unless the applicant qualifies for § 162O or receives a commissioner waiver.
Renewal waiver
Under § 162M(d), military service or another extenuating circumstance may support waiver of renewal procedures, an examination requirement, a fine or a sanction.
Reinstate a lapsed individual producer license within 12 months
No examination is required for this applicant pathway.
Continuing education
Satisfy applicable CE obligations. Section 162M(c) expressly dispenses with a written licensing examination.
Deadline
Apply within 12 months of the renewal-fee due date.
Penalty
Pay double the unpaid renewal fee for a renewal received after the due date.

Official no-examination sources

Effective from 2026-09-22.

Renewal of an active individual producer license
No examination is required for this applicant pathway.
Continuing education
Resident individual producers complete 60 approved hours before initial renewal and 45 hours in each subsequent 36-month period, including 3 Massachusetts-approved ethics hours; statutory and regulatory exemptions apply.
Nonresident education
Home-jurisdiction CE satisfies Massachusetts CE when reciprocal recognition and equivalent licensing requirements are met.
Renewal
Pay the prescribed renewal fee by the due date; the license remains effective unless revoked or suspended.

Official no-examination sources

Effective from 2026-09-22.

Change resident or nonresident status after a move outside Massachusetts
No examination is required for this applicant pathway.
Application
Section 162N(c) requires no new license application or fee.
Move
A nonresident producer changing home jurisdiction, or a resident producer moving out of Massachusetts, files the address change and new resident-jurisdiction certification within 30 days.

Official no-examination sources

Effective from 2026-09-22.

Add Accident and Health or Sickness to an active nonresident producer license
No examination is required for this applicant pathway.
Application
Use NIPR's Add a Line of Authority application; NIPR verifies the home license and line in the Producer Database.
Existing license
Hold an active Massachusetts nonresident producer license and the requested health authority in the home jurisdiction.

Official no-examination sources

Effective from 2026-09-22.

Nonresident issuance by reciprocity
No examination is required for this applicant pathway.
Application
Submit the prescribed request or uniform application and fees; licensing status may be verified through NAIC records.
Home examinations
Any home-jurisdiction licensing examination is an applicant qualification; it is not a Massachusetts examination leaf.
Home license
Currently resident-licensed in good standing for the requested authority in the home jurisdiction.
Reciprocity
The home jurisdiction must award nonresident licenses to Massachusetts residents on the same basis.

Official no-examination sources

Effective from 2026-09-22.

Add Accident and Health or Sickness to an active resident producer license
Producer - Accident and Health or Sickness
Application
Pass the applicable health producer exam and submit NIPR's Add a Line of Authority application.
Continuing education
The Division states that adding this line ends any pre-April 4, 1983 grandfathered CE status.
Existing license
Hold an active individual resident producer license in another line.
Vendor update
The older add-line page still directs applicants to Prometric. The Division's express July 22, 2026 transition notice and its individual-producer page direct current testing through Pearson.
Resident licensure by examination
Producer - Accident and Health or Sickness
Application
Submit the uniform application and prescribed fees; after passing, apply through NIPR. Passing does not itself issue a license.
Fitness
No act constituting a ground for denial, suspension or revocation under § 162R; disclose background information truthfully on the uniform application.
Line of authority
Apply for Accident and Health or Sickness; other lines on the same license have their own requirements.
Minimum age
At least 18 years old under § 162L(a)(1).
Prelicensing education
Complete a prelicensing course when required by the commissioner under § 162L(a)(3).
Resident issuance to an applicant previously licensed for the same line
No examination is required for this applicant pathway.
Application
Meet the resident application requirements of § 162L, subject to the express education and examination exemption in § 162O(a).
Good standing
The prior jurisdiction certifies good standing at cancellation or NAIC producer records show current or former good standing for the requested line.
Same line
Previously licensed for the same requested line of authority elsewhere; that license is currently active, or application is received within 90 days after cancellation.

Official no-examination sources

Effective from 2026-09-22.

Resident issuance on relocation to Massachusetts
No examination is required for this applicant pathway.
Continuing education
Complete 60 CE credits, including 3 ethics credits, before the initial Massachusetts renewal; the Division states this applies regardless of the length of the initial license term.
Prior license
The prior line and good standing must be verifiable. The prior license must be cancelled as part of conversion rather than first converted to nonresident status.
Regulatory exception
Section 162O(b) permits an exception by commissioner regulation. The current implementing individual-producer page directs resident conversion through NIPR and states the initial Massachusetts CE obligation.
Relocation
Previously licensed for the same line and moving legal residence to Massachusetts; apply within 90 days of establishing legal residence under § 162O(b).

Official no-examination sources

Effective from 2026-09-22.

Massachusetts Nonresident Limited Lines Producer License

A nonresident limited-lines producer license granting the same scope as the home-state license, with authority narrower than an associated major line.

Licensing authority: Massachusetts Division of Insurance · Application information

Nonresident issuance for restricted health authority
No examination is required for this applicant pathway.
Home examinations
Any home-jurisdiction examination is prior applicant qualification, not a Massachusetts examination leaf.
Reciprocity
Meet § 162N(a): resident licensing and good standing, uniform application or home application, fees, and reciprocal nonresident licensing.
Restricted authority
Hold a limited-lines producer license in the home jurisdiction that restricts accident and health or sickness authority to less than the full major line; Massachusetts grants the same scope under § 162N(e).

Official no-examination sources

Effective from 2026-09-22.

Renewal of a nonresident limited lines producer license
No examination is required for this applicant pathway.
Home examinations
Any home-jurisdiction examination is prior applicant qualification, not a Massachusetts examination leaf.
Reciprocity
Meet § 162N(a): resident licensing and good standing, uniform application or home application, fees, and reciprocal nonresident licensing.
Renewal
Pay the renewal fee and maintain the qualifying home license and reciprocal CE status where applicable.
Restricted authority
Hold a limited-lines producer license in the home jurisdiction that restricts accident and health or sickness authority to less than the full major line; Massachusetts grants the same scope under § 162N(e).

Official no-examination sources

Effective from 2026-09-22.

temporary insurance producer license

A temporary producer license for servicing an existing health insurance business, issued without examination for no more than 180 days.

Licensing authority: Massachusetts Division of Insurance · Application information

Temporary issuance to a business entity member or employee
No examination is required for this applicant pathway.
Commissioner determination
The commissioner must find temporary licensing necessary to service the insurance business.
Duration
No more than 180 days, and no continuation after disposal of the business by the owner or personal representative.
Eligibility
An individual designated in the licensed business entity's application or license died or became disabled.
Restrictions
The commissioner may limit authority, require a licensed producer or insurer sponsor responsible for the licensee, impose protective conditions, or revoke the license to protect insureds and the public.

Official no-examination sources

Effective from 2026-09-22.

Temporary issuance to a producer's military service designee
No examination is required for this applicant pathway.
Commissioner determination
The commissioner must find temporary licensing necessary to service the insurance business.
Duration
No more than 180 days, and no continuation after disposal of the business by the owner or personal representative.
Eligibility
The licensed producer enters active United States armed-forces service and designates the applicant.
Restrictions
The commissioner may limit authority, require a licensed producer or insurer sponsor responsible for the licensee, impose protective conditions, or revoke the license to protect insureds and the public.

Official no-examination sources

Effective from 2026-09-22.

Temporary issuance in another public interest circumstance
No examination is required for this applicant pathway.
Commissioner determination
The commissioner must find temporary licensing necessary to service the insurance business.
Duration
No more than 180 days, and no continuation after disposal of the business by the owner or personal representative.
Eligibility
The commissioner determines that another circumstance warrants temporary issuance in the public interest.
Restrictions
The commissioner may limit authority, require a licensed producer or insurer sponsor responsible for the licensee, impose protective conditions, or revoke the license to protect insureds and the public.

Official no-examination sources

Effective from 2026-09-22.

Temporary issuance to a surviving spouse or court appointed personal representative
No examination is required for this applicant pathway.
Commissioner determination
The commissioner must find temporary licensing necessary to service the insurance business.
Duration
No more than 180 days, and no continuation after disposal of the business by the owner or personal representative.
Eligibility
The licensed producer died or became mentally or physically disabled; issuance allows business sale, recovery or return, or training and licensing of replacement personnel.
Restrictions
The commissioner may limit authority, require a licensed producer or insurer sponsor responsible for the licensee, impose protective conditions, or revoke the license to protect insureds and the public.

Official no-examination sources

Effective from 2026-09-22.

Producer - Accident and Health or Sickness

Provider
Pearson Professional Assessments
Format
Computer-based written examination at an authorized test center
Exam questions
General knowledge: 50 scored plus 5 pretest questions; Massachusetts specific: 30 scored plus 5 pretest questions
Passing score
70 on the equated scaled-score scale
Exam fee
$37
Examination outline
  • General Knowledge — I. Types of Policies
    • A. Disability income
    • A.1. Individual disability income policy
    • A.2. Business overhead expense policy
    • A.3. Business disability buyout policy
    • A.4. Group disability income policy
    • A.5. Key employee policy
    • B. Accidental death and dismemberment
    • C. Medical expense insurance
    • C.1. Basic hospital, medical, and surgical policies
    • C.2. Major medical policies
    • C.3. Health Maintenance Organizations (HMOs)
    • C.4. Preferred Provider Organizations (PPOs)
    • C.5. Point of Service (POS) plans
    • C.6. Flexible Spending Accounts (FSAs)
    • C.7. High Deductible Health Plans (HDHPs) and related Health Savings Accounts (HSAs)
    • C.8. Health Reimbursement Accounts (HRAs)
    • D. Medicare supplement policies
    • E. Group insurance
    • E.1. Differences between individual and group contracts
    • E.2. General characteristics
    • E.3. COBRA
    • F. Individual/Group Long Term Care (LTC)
    • F.1. Eligibility
    • F.2. Levels of care
    • G. Other policies
    • G.1. Dental
    • G.2. Vision
    • G.3. Cancer
    • G.4. Critical illness or specified disease
    • G.5. Worksite (employer-sponsored)
    • G.6. Hospital indemnity
    • G.7. Short-term medical
    • G.8. Accident
  • General Knowledge — II. Policy Provisions, Clauses, and Riders
    • A. Mandatory and optional provisions
    • A.1. Entire contract
    • A.2. Time limit on certain defenses (incontestable)
    • A.3. Grace period
    • A.4. Reinstatement
    • A.5. Notice of claim
    • A.6. Claim forms
    • A.7. Proof of loss
    • A.8. Time of payment of claims
    • A.9. Payment of claims
    • A.10. Physical examination and autopsy
    • A.11. Legal actions
    • A.12. Change of beneficiary
    • A.13. Misstatement of age or gender
    • A.14. Change of occupation
    • A.15. Illegal occupation
    • A.16. Relation of earnings to insurance
    • B. Other provisions and clauses
    • B.1. Insuring clause
    • B.2. Free look
    • B.3. Consideration clause
    • B.4. Probationary period
    • B.5. Elimination period
    • B.6. Waiver of premium
    • B.7. Exclusions and limitations
    • B.8. Preexisting conditions
    • B.9. Coinsurance
    • B.10. Deductibles
    • B.11. Eligible expenses
    • B.12. Copayments
    • B.13. Pre-authorizations and prior approval requirements
    • B.14. Usual, reasonable, and customary (URC) charges
    • B.15. Lifetime, annual, or per cause maximum benefit limits
    • C. Riders
    • C.1. Impairment/exclusions
    • C.2. Guaranteed insurability
    • C.3. Future increase option
    • D. Rights of renewability
    • D.1. Noncancelable
    • D.2. Cancelable
    • D.3. Guaranteed renewable
  • General Knowledge — III. Social Insurance
    • A. Medicare (Parts A, B, C, D)
    • B. Medicaid
    • C. Social Security benefits
  • General Knowledge — IV. Other Insurance Concepts
    • A. Total, partial, recurrent, and residual disability
    • B. Owner’s rights
    • C. Dependent children benefits
    • D. Primary and contingent beneficiaries
    • E. Modes of premium payments
    • F. Nonduplication and coordination of benefits (e.g., primary vs. excess)
    • G. Occupational vs. non-occupational
    • H. Tax treatment of premiums and proceeds of insurance contracts (e.g., disability income and medical expenses, etc.)
    • I. Managed care
    • J. Workers’ Compensation
    • K. Subrogation
  • General Knowledge — V. Field Underwriting Procedures
    • A. Completing the application
    • B. Explaining sources of insurability and HIPAA privacy information (e.g., MIB Report, Fair Credit Reporting Act, etc.)
    • C. Initial premium payment and receipt and consequences of the receipt (e.g., medical examination, etc.)
    • D. Submitting application (and initial premium if collected) to company for underwriting
    • E. Policy delivery
    • F. Explaining policy and its provisions, riders, exclusions, and ratings to clients
    • G. Replacement
    • H. Contract law
    • H.1. Elements of a contract
    • H.2. Insurable interest
    • H.3. Warranties and representations
    • H.4. Unique aspects of the insurance contract
    • H.4.a. Conditional
    • H.4.b. Unilateral
    • H.4.c. Adhesion
    • H.4.d. Aleatory
  • Massachusetts Specific — I. Massachusetts Laws and Rules Pertinent to All Lines of Insurance
    • A. Licensing
    • A.1. Process
    • A.2. Types of licenses
    • A.2.a. Producers
    • A.2.b. Business entity producers
    • A.2.c. Nonresident producers
    • A.2.d. Temporary
    • A.2.e. Advisers
    • A.2.f. Reinsurance intermediaries
    • A.2.g. Exemptions
    • A.3. Maintenance and duration
    • A.3.a. Reinstatement and renewal
    • A.3.b. Address change
    • A.3.c. Reporting of actions
    • A.3.d. Assumed names
    • A.3.e. Continuing education requirements, exemptions and penalties
    • A.4. Disciplinary actions
    • A.4.a. Cease and desist order
    • A.4.b. Hearings
    • A.4.c. Probation, suspension, revocation, refusal to issue or renew
    • A.4.d. Penalties and fines
    • B. State Regulation
    • B.1. Commissioner’s general duties and powers
    • B.2. Company regulation
    • B.2.a. Certificate of authority
    • B.2.b. Solvency
    • B.2.c. Rates
    • B.2.d. Policy forms
    • B.2.e. Examination of books and records
    • B.2.f. Producer appointments
    • B.2.g. Termination of producer appointment
    • B.3. Producer regulation
    • B.3.a. Impersonation
    • B.3.b. Larceny
    • B.3.c. Unlicensed persons compensation
    • B.3.d. Commissions
    • B.3.e. Records Retention
    • B.3.f. Insurance transactions
    • B.4. Unfair or deceptive practices
    • B.4.a. Misrepresentation
    • B.4.b. False advertising
    • B.4.c. Defamation of insurer
    • B.4.d. Boycott, coercion, intimidation
    • B.4.e. False financial statements
    • B.4.f. Failure to maintain a complaint record
    • B.4.g. Unfair discrimination
    • B.4.h. Unfair claims settlement practices
    • B.4.i. Rebating
    • B.5. Insurance fraud regulation
    • B.6. Insurance Information and Privacy Protection
    • B.7. Types of Insurers
    • B.7.a. Foreign, Alien, Domestic
    • B.7.b. Authorized and unauthorized insurers
    • B.7.c. Stock and mutual insurers
  • Massachusetts Specific — II. Massachusetts Laws and Regulations Pertinent to Accident, Health or Sickness Insurance Only
    • A. Life and Health Insurance Guaranty Association Law
    • B. Producer responsibilities in individual accident, health or sickness insurance
    • B.1. Advertising
    • B.1.a. Sales presentations
    • B.1.b. Outline of coverage
    • B.1.c. Disclosure of information about individuals
    • C. Individual underwriting by the insurer
    • C.1. Medical examinations and lab tests (including HIV consent)
    • C.2. Genetic information
    • D. Replacement of Accident, Health, or Sickness Insurance
    • D.1. Massachusetts replacement requirements
    • D.2. Massachusetts individual mandate for minimum creditable coverage requires individual to have health insurance even if the person has accident/sickness
    • E. Required Policy Provisions
    • E.1. Entire contract; changes
    • E.2. Time limit on certain defenses
    • E.3. Grace period
    • E.4. Reinstatement
    • E.5. Claim procedures
    • E.6. Physical examinations and autopsy
    • E.7. Legal actions
    • E.8. Change of beneficiary
    • E.9. Right to examine (free look)
    • F. Optional Policy Provisions
    • F.1. Change of occupation
    • F.2. Misstatement of age
    • F.3. Other insurance in this insurer
    • F.4. Expense-incurred basis
    • F.5. Other benefits
    • F.6. Unpaid premium
    • F.7. Conformity with state statutes
    • F.8. Illegal occupation
    • G. Health Insurance Provisions
    • G.1. Massachusetts eligibility requirements (Open enrollment)
    • G.1.a. Dependent child age limit
    • G.1.b. Disabled adult children
    • G.1.c. Newborn child coverage
    • G.1.d. Coverage of adopted children
    • G.2. Affordable Care Act (ACA) and Massachusetts Health Connector
    • G.2.a. Guaranteed issue
    • G.2.b. Guaranteed renewability
    • G.2.c. Preventive care
    • G.2.d. Emergency services
    • G.2.e. Health status (no discrimination)
    • G.2.f. EHB coverage
    • G.3. Massachusetts Mental Health Parity
    • G.4. Employer group health insurance
    • G.4.a. Nondiscrimination
    • G.4.b. Eligibility for coverage
    • G.4.c. Employee eligibility
    • G.4.d. Coordination of benefits provision (COB)
    • G.4.e. Continuation of coverage under COBRA and Massachusetts specific rules
    • G.5. Small employer and individual medical plans
    • G.5.a. Definition of small employer
    • G.5.b. Availability and eligibility rating rules
    • G.5.c. Restrictions relating to premiums
    • G.5.d. Small group continuation
    • G.5.e. Renewability
    • H. Medicare supplement policies
    • H.1. Open enrollment
    • H.2. Standardized Medicare supplement plans
    • H.2.a. Core benefits, Supplement 1
    • H.3. Massachusetts regulations and required provisions — Advertising
    • H.4. Standards for marketing
    • H.5. Permitted compensation
    • H.6. Appropriateness of recommended purchase and excessive insurance
    • H.7. Required disclosure provisions
    • H.8. Reporting of multiple policies
    • H.9. Buyer's guide
    • H.10. Right to return
    • H.11. Replacement
    • H.12. Benefit standards
    • H.13. Pre-existing conditions
    • H.14. Renewability
    • H.15. Outline of coverage
    • I. MassHealth
    • I.1. Eligibility
    • I.2. Benefits
    • J. Long-Term Care (LTC) Insurance
    • J.1. Home health care
    • J.2. Exclusions
    • J.3. Massachusetts regulations and required provisions
    • J.3.a. Standards for marketing
    • J.3.b. Suitability of recommended purchase
    • J.3.c. Your Options for Financing Long-Term Care
    • J.3.d. Outline of coverage
    • J.3.e. Non-forfeiture benefit offer
    • J.3.f. Required disclosure provisions
    • J.3.g. Right to return
    • J.3.h. Policy illustration
    • J.3.i. Inflation adjustment benefit
    • J.3.j. MassHealth exemption
    • J.3.k. Benefit triggers
    • J.3.l. Unintentional lapse
Examination sources