Health field underwriting and other concepts practice questions (Massachusetts)
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Two general sections of the Massachusetts Accident, Health or Sickness Producer exam are covered here: "Other Insurance Concepts" (5 scored questions) and "Field Underwriting Procedures" (8). [1] The outline lists total, partial, recurrent and residual disability, owner's rights, dependent children, beneficiaries, premium modes, coordination of benefits, occupational versus non-occupational coverage, taxes, managed care, workers compensation and subrogation, then the application, sources of insurability and privacy, the premium receipt, submitting the application, delivery, replacement and contract law. [1] This page gives 10 practice questions from the Division of Insurance's disability glossary and consumer guide and from Massachusetts law.
Disability definitions, from the Division's glossary
- Total disability: inability, due to injury or illness, to perform the material and substantial duties. [2]
- Partial disability: inability to perform those duties on a full-time basis. [2]
- Residual disability: inability to perform all of the material and substantial duties. [2]
- Recurrent disability: in the glossary's individual policy section, recurrent disabilities "may not be separated by a period of greater than six months." [2]
Practice questions
1. An insured can still work, but not full time, because of an illness. Which definition fits best?
A. Total disability
B. Partial disability
C. Presumptive disability
D. Permanent disability
Answer: B. Partial disability is the inability to perform the material and substantial duties on a full-time basis. [2]
2. An insured can do some, but not all, of the material and substantial duties. Which term describes this?
Answer: Residual disability. [2]
3. In the glossary's individual policy section, how far apart can recurrent disabilities be?
Answer: Not more than six months. [2]
4. Up to what age must a Massachusetts family health policy cover children?
Answer: Under 26, plus children who are mentally or physically incapable of earning their own living. (M.G.L. c. 175, s. 108) [3]
5. When does a newborn's coverage begin under a Massachusetts policy that covers dependents?
Answer: Immediately from the moment of birth. (M.G.L. c. 175, s. 47C) [4]
6. An applicant's misstatement was not intended to deceive and did not increase the risk of loss. Can it defeat the policy in Massachusetts?
Answer: No. A misrepresentation or warranty in negotiating a policy does not defeat it unless made with actual intent to deceive or the matter increased the risk of loss. (M.G.L. c. 175, s. 186(a)) [5]
7. When must the applicant receive a notice of information practices?
Answer: No later than when the application is made, and it must be in writing. (M.G.L. c. 175I, s. 4) [6]
8. What is a "self-funded" employer plan?
Answer: One where the employer pays health claims from its own funds. [7]
9. What do health plans use utilization review for?
Answer: To decide if a service is necessary according to their medical standards. [7]
10. A person leaves a group covered under a Massachusetts group policy. How long do they stay insured?
Answer: Thirty-one days, unless they become entitled to similar benefits during that time. (M.G.L. c. 175, s. 110D) [8]
Two more group rules in Massachusetts law
- Involuntary layoff or death (M.G.L. c. 175, s. 110G): when a member of a group hospital, surgical or medical plan loses eligibility because of involuntary layoff or death, coverage for the member, spouse and dependents continues for up to thirty-nine weeks, or until they become eligible under another group plan, whichever comes first. [9]
- Divorce (M.G.L. c. 175, s. 110I): after a judgment of divorce or separate support, the former spouse stays eligible under the member's group plan without additional premium or examination, unless the judgment says otherwise. [10]
Study tips
- Disability words: total (cannot do the duties), partial (not full time), residual (not all duties), recurrent (within six months in the glossary's policy section).
- Dependents: under 26 in Massachusetts, newborns from the moment of birth.
Practice more with the free Massachusetts Accident and Health practice test.
Prep Retention is independent and is not affiliated with Pearson VUE or the state.
Sources
- Pearson VUE, Massachusetts content outlines 122301 (effective July 22, 2026): https://www.pearsonvue.com/content/dam/VUE/vue/en/documents/publications/122301.pdf
- Massachusetts Division of Insurance, Appendix A, Glossary of Common Disability Income Terminology: https://www.mass.gov/doc/appendixa2010pdf/download
- M.G.L. c. 175, s. 108: https://malegislature.gov/Laws/GeneralLaws/PartI/TitleXXII/Chapter175/Section108
- M.G.L. c. 175, s. 47C: https://malegislature.gov/Laws/GeneralLaws/PartI/TitleXXII/Chapter175/Section47C
- M.G.L. c. 175, s. 186: https://malegislature.gov/Laws/GeneralLaws/PartI/TitleXXII/Chapter175/Section186
- M.G.L. c. 175I, s. 4: https://malegislature.gov/Laws/GeneralLaws/PartI/TitleXXII/Chapter175I/Section4
- Massachusetts Division of Insurance, Consumer Guide to Understanding Health Insurance: https://www.mass.gov/info-details/consumer-guide-to-understanding-health-insurance
- M.G.L. c. 175, s. 110D: https://malegislature.gov/Laws/GeneralLaws/PartI/TitleXXII/Chapter175/Section110D
- M.G.L. c. 175, s. 110G: https://malegislature.gov/Laws/GeneralLaws/PartI/TitleXXII/Chapter175/Section110G
- M.G.L. c. 175, s. 110I: https://malegislature.gov/Laws/GeneralLaws/PartI/TitleXXII/Chapter175/Section110I