What This License Is
The Massachusetts Accident and Health or Sickness line lets you sell health, disability, long-term care, Medicare supplement and related coverage in the Commonwealth. It is issued by the Division of Insurance and sits on the same producer license as any other line you hold.
It is genuinely standalone. Massachusetts offers no combined Life & Accident and Health exam — a producer who wants both sits two exams and pays $37 twice. That is worth knowing up front because national prep material almost universally assumes a combined sitting exists.
The other thing to know before you study: Massachusetts health law is not a variation on the national theme, it is a different theme. Chapter 58 of 2006 built the individual mandate, the Connector and the merged market years before the ACA, and the Commonwealth kept all of it. A candidate who studies only national material walks into the state section with the wrong answers to the most heavily tested questions.
Exam Options & Format
The Accident & Health or Sickness Producer exam is 80 scored questions plus 10 unscored pretest items — 50 scored general-knowledge and 30 scored Massachusetts-specific — for $37 through Pearson VUE.
There is no combined option to weigh against it. If you also want life authority, that is the separate Life Producer exam at another $37, and it can be sat any time — before, after, or years later. Both lines then appear on one license, and the license fee does not change.
The passing standard is a scaled score of 70 — and that is not the same thing as 70% correct. The handbook is blunt about it: the reported score "is neither the number of questions answered correctly nor the percentage of questions answered correctly." Raw answers are converted onto a common scale so that a slightly harder form is not a harder pass.
Massachusetts does not publish a time limit. The handbook describes how the on-screen clock behaves and then says the number of questions and the time limit "can be found in the exam's content outline" — but the published outlines carry topic weightings and question counts, not minutes. Treat any site quoting you a Massachusetts exam duration as quoting the old Prometric handbook. Your actual limit is confirmed when you book and shown on screen when you sit down.
Scheduling runs through Pearson VUE's Massachusetts portal, and appointments can be made as late as one calendar day before you want to test, subject to availability. Testing is in person only — remote proctoring ended when the state moved off Prometric on July 22, 2026.
Most Tested Topics on the Massachusetts Accident & Health Exam
This is the line where the state section earns its keep. Every rule below differs from what a national course will have taught you, and each is cited to its statute or regulation:
| Concept | The Massachusetts rule |
|---|---|
| Individual mandate | Still in force. Massachusetts never repealed Chapter 58's mandate (c. 111M § 2). For tax year 2026 the penalty runs from $0 at or below 150% of the federal poverty level up to $211 a month — $2,532 a year above 400% FPL. The federal penalty is $0; this one is not |
| Minimum Creditable Coverage | Coverage must meet MCC standards set by the Health Connector to satisfy the mandate — a Massachusetts-only concept (956 CMR 5.00) |
| Marketplace | A state-based exchange: the Massachusetts Health Connector, created by c. 176Q. Open enrollment for the 2026 plan year ran November 1, 2025 through January 23, 2026 — later than the federal January 15 |
| Medicaid | MassHealth, expanded under the ACA effective January 1, 2014 (CarePlus for adults to 133% FPL). CHIP is administered inside MassHealth with no separate brand |
| Clean-claim payment | 45 days under the preferred provider arrangements statute — and Massachusetts applies the same deadline to paper and electronic claims, with no split. Interest runs at 1.5% per month, up to 18% a year, from day 45 (c. 176I § 2) |
| External review | The independent review decision binds the carrier and is run by the Office of Patient Protection, with a 45-day standard decision (c. 176O § 14) and a 72-hour expedited track under the same chapter |
| Mini-COBRA | Employers with 2–19 employees — the groups federal COBRA misses. 18 months for termination or reduced hours, 36 months for death, divorce, Medicare eligibility or loss of dependent status, 29 months on disability; 60 days to elect; premium capped at 102% of the group rate, 150% during the disability extension (c. 176J § 9) |
| Small group | 1 to 50 eligible employees, counted on at least 50% of working days in the preceding year — and Massachusetts merges the non-group and small-group markets into one risk pool, which very few states do (c. 176J § 1) |
| Grace period, A&H | Tiered by premium mode: 7 days weekly-premium, 10 days monthly-premium, 31 days everything else (c. 175 § 108) |
| Time limit on certain defenses | 2 years — after two years no misstatement except a fraudulent one may void the policy or deny a claim (§ 108) |
| Medicare supplement | Massachusetts is a waiver state: only three standardized plans exist — Core, Supplement 1 (open only to those Medicare-eligible before 1/1/2020) and Supplement 1A. Not plans A–N. Guaranteed issue with no preexisting-condition waiting period at all, an annual open enrollment February 1 – March 31 effective June 1, and a 30-day free look (211 CMR 71.00, implementing c. 176K; the current plan names come from the DOI's Medicare supplement information document, updated 12/29/2025) |
| Long-term care training | Carrier-provided product training is required before you may sell LTC (211 CMR 65.08). Massachusetts has no LTC Partnership program, so there is no partnership-specific training to complete |
If you only have time to nail one item, make it Medicare supplement. A national course teaches plans A through N, a one-time six-month Medigap open enrollment beginning at 65 and Part B enrollment, and a permitted six-month preexisting-condition exclusion. In Massachusetts all three of those are wrong — three plans, an annual February-to-March open enrollment, and no preexisting-condition limitation whatsoever. That single topic can swing several state-section questions.
The second most-missed item is the mandate, and specifically the assumption that it went away with the federal one. It did not. The third is the merged market: candidates who know small group as "2–50" elsewhere miss that Massachusetts counts from one employee and pools that risk with the individual market.
The Application's Background Questions — What They Ask and Why They Matter
Most states run your fingerprints. Massachusetts does not — there is no fingerprint requirement, no vendor, and no criminal-record check for a resident producer license. The consequence is easy to miss: your written disclosures on the NIPR application are the background check. There is no second system quietly verifying you. What you write is what the Division reviews.
What the application asks. The NAIC uniform background questions cover criminal history (felony and misdemeanor convictions, pending charges, pretrial diversion), administrative actions by any insurance department or other regulator in any jurisdiction, professional licenses denied, suspended or revoked, unsatisfied judgments or liens, business bankruptcies, unpaid child support, delinquent state taxes, and terminations for cause by an insurer.
What actually matters to the Division. Section 162R lists fourteen grounds on which the Commissioner may refuse, suspend or revoke a license. Several map directly onto disclosure answers: a felony conviction; fraudulent, coercive or dishonest practices, or demonstrated incompetence, untrustworthiness or financial irresponsibility; a license denied, suspended or revoked in another jurisdiction; improperly withholding or converting money or property; failure to comply with a child support obligation; and failure to pay state income tax. Two more are worth reading twice, because candidates never expect them: improperly using notes or reference material to complete a licensing examination is itself a statutory ground for discipline, and so is knowingly accepting insurance business from someone who is not licensed.
Disclose, then explain. The single worst outcome is a matter the Division learns about from somewhere other than you. Providing incorrect, misleading, incomplete or materially untrue information in the application is § 162R ground number one, and obtaining a license through misrepresentation is ground number three — both are independent of whatever you failed to disclose. A ten-year-old misdemeanor disclosed with the court disposition attached is routine. The same misdemeanor discovered later is two violations instead of none.
What to attach. For any "yes," upload the underlying documents: certified court records showing the charge and its disposition, the regulator's consent order or final decision, proof that a judgment was satisfied or a payment plan is current, and a signed letter of explanation in your own words — what happened, when, what you did about it, and what has changed. Documents go up with the application; sending them later slows review.
The duty does not stop at licensure. Section 162V makes reporting continuous. You must report any administrative action to the Division within 30 days of the final disposition, including a copy of the order and any relevant documents, and any criminal prosecution within 30 days of the initial pretrial hearing date, with the charging documents. Note the trigger on the criminal side: it is the pretrial hearing, not a conviction. You report while the case is pending, not after it resolves.
If a question comes back. The Division may ask for more before it decides. Answer promptly and completely — an unanswered request is the most common cause of an application sitting still. A denial is not the end either: it is an administrative decision, and the practical response is usually to cure the deficiency and reapply with better documentation rather than to argue the facts.
What It Costs
$37 for the exam and $225 for the three-year license — about $262 on a first-attempt pass, plus NIPR's transaction fee. No pre-licensing tuition, no fingerprint fee.
The $225 figure holds because an A&H-only license carries no Property, Casualty or Personal Lines authority. Add any of those three later and the license fee becomes $300 at the next transaction — the extra $75 is the lead paint surcharge, charged once per term regardless of how many of those three lines you hold.
Eligibility Requirements
You must be at least 18 years old and, for a resident license, maintain your residence or principal place of business in Massachusetts (M.G.L. c. 175 § 162L). There is no citizenship requirement and no education requirement beyond passing the exam.
Massachusetts does not fingerprint resident producer applicants. Your background is reviewed through the application's written disclosure questions instead — and that duty does not end at licensure: § 162V requires you to report any administrative action to the Division within 30 days of final disposition, and any criminal prosecution within 30 days of the initial pretrial hearing date, with copies of the underlying documents. For a health producer, note that the disclosure questions reach beyond criminal history into unpaid child support and delinquent state taxes — both are enumerated grounds under § 162R.
Keeping Your License Active
Important CE details: Massachusetts runs a 36-month CE cycle. Your first renewal after original licensure requires 60 credits; every renewal after that requires 45. Either way, 3 hours must be Massachusetts-approved ethics — coded MAE in the CE system. Excess classroom hours carry forward, but only one cycle. Selling long-term care additionally requires carrier-provided product training under 211 CMR 65.08 before your first LTC sale.
Renewal is triennial and anchored to your birth month, with a first term prorated to land there. CE is 60 credits before your first renewal and 45 for every renewal after, always including 3 hours of Massachusetts-approved ethics (course code MAE). Excess classroom hours carry forward exactly one cycle.
Health producers pick up product training rather than extra hours. Before your first long-term care sale you need the carrier's LTC product training under 211 CMR 65.08 — and because Massachusetts runs no LTC Partnership program, there is no partnership course layered on top, which is a difference from most states. If you add the Life line later, the one-time 4-credit annuity best-interest training comes with it.
NIPR will not accept a renewal submission until your CE compliance posts, and posting can take up to 72 hours. The Property & Casualty guide covers the full renewal mechanics, including the 90-day early window and what happens if you miss the date.
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