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Massachusetts health insurance exam flashcards

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The Massachusetts Accident, Health or Sickness Producer exam has 15 scored questions on "Massachusetts Laws and Regulations Pertinent to Accident, Health or Sickness Insurance Only." That section covers required and optional policy provisions, health insurance provisions, Medicare supplement policies, MassHealth and long-term care, among other topics. [1] These flashcards cover the rules from the Massachusetts General Laws behind several of those topics. Each answer names the section of law it comes from.

Required provisions (175:108)

1. Who can change an individual accident and sickness policy?
Only an executive officer of the insurer, with the approval endorsed on or attached to the policy. No agent can change the policy or waive its provisions. (175:108) [2]

2. In the "Time Limit on Certain Defenses" provision, after how long can non-fraudulent misstatements no longer void the policy?
Two years from the date of issue. (175:108) [2]

3. What grace periods must be allowed?
Not less than 7 days for weekly premium policies, 10 days for monthly, and 31 days for all others. (175:108) [2]

4. The insurer takes a reinstatement application, issues a conditional receipt and does not act. When is the policy reinstated?
On the forty-fifth day after the date of the conditional receipt, unless the insurer has notified the insured in writing before then that it disapproves the application. (175:108) [2]

5. When must written notice of claim be given?
Within twenty days after the loss starts, or as soon after as reasonably possible. (175:108) [2]

6. The insurer does not send claim forms. How long before the claimant can file proof without them?
Fifteen days after notice of claim. (175:108) [2]

7. When is proof of loss due?
Within ninety days after the loss. If that is not reasonably possible, as soon as it is, and except without legal capacity, no later than one year. (175:108) [2]

8. How often must periodic benefits be paid?
Not less often than monthly. (175:108) [2]

9. With no beneficiary designation in effect, who receives the benefit for loss of life?
The insured's estate. (175:108) [2]

10. Can the insurer examine the insured during a claim?
Yes, at its own expense, as often as it reasonably requires while the claim is pending. (175:108) [2]

11. What are the time limits on lawsuits?
None until sixty days after written proof of loss, and none after three years from when proof of loss is required. (175:108) [2]

12. Unless the designation is irrevocable, who controls changing the beneficiary?
The insured. (175:108) [2]

Dependents and newborns

13. Up to what age must a family policy cover children?
Children under 26 years of age, plus children who are mentally or physically incapable of earning their own living. (175:108) [2]

14. For an incapacitated child, when must proof of the incapacity reach the insurer?
Within 31 days of the date coverage would otherwise end. (175:108) [2]

15. When does coverage for a newborn start under a policy that covers dependents?
Immediately from the moment of birth. (175:47C) [3]

16. What must newborn and adoptive child coverage include?
Injury or sickness, including care and treatment of medically diagnosed congenital defects and birth abnormalities, or premature birth. (175:47C) [3]

Group continuation

17. A person leaves a group covered under section 110. How long do they stay insured?
Thirty-one days, unless they become entitled to similar benefits during that time. (175:110D) [4]

18. A group member loses eligibility because of involuntary layoff or death. How long does coverage continue?
Up to thirty-nine weeks from the date of ineligibility, or until the member, spouse and dependents become eligible under another group plan, whichever comes first. (175:110G) [5]

19. After a divorce judgment, can the former spouse stay on the member's group plan?
Yes, without additional premium or examination, as if the judgment had not been entered, unless the judgment says otherwise. (175:110I(a)) [6]

Medicare supplement (chapter 176K)

20. Can a Medicare supplement policy have a waiting period or pre-existing condition exclusion?
No. (176K:3(b)) [7]

21. When is the yearly Medicare supplement open enrollment period?
February first through March thirty-first. Coverage is effective June first of that year, or no later than when Medicare coverage first takes effect, whichever is earlier. (176K:3(d)) [7]

22. A person just became eligible. Can a carrier deny or price them differently if they apply within the first six months?
No. Carriers cannot deny, condition or price differently during the six months beginning when the person first becomes eligible. (176K:3(c)) [7]

How to use these cards

Practice with the free Massachusetts Accident and Health practice test.

Prep Retention is independent and is not affiliated with Pearson VUE or the state.

Sources

Laws and exam documents quoted as of October 2026.

  1. Pearson VUE, Massachusetts content outlines 122301 (effective July 22, 2026): https://www.pearsonvue.com/content/dam/VUE/vue/en/documents/publications/122301.pdf
  2. M.G.L. c. 175, s. 108: https://malegislature.gov/Laws/GeneralLaws/PartI/TitleXXII/Chapter175/Section108
  3. M.G.L. c. 175, s. 47C: https://malegislature.gov/Laws/GeneralLaws/PartI/TitleXXII/Chapter175/Section47C
  4. M.G.L. c. 175, s. 110D: https://malegislature.gov/Laws/GeneralLaws/PartI/TitleXXII/Chapter175/Section110D
  5. M.G.L. c. 175, s. 110G: https://malegislature.gov/Laws/GeneralLaws/PartI/TitleXXII/Chapter175/Section110G
  6. M.G.L. c. 175, s. 110I: https://malegislature.gov/Laws/GeneralLaws/PartI/TitleXXII/Chapter175/Section110I
  7. M.G.L. c. 176K, s. 3: https://malegislature.gov/Laws/GeneralLaws/PartI/TitleXXII/Chapter176K/Section3

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