What This License Is
The Michigan Accident and health or sickness line of authority sits at MCL 500.1206(1)(b). It covers major medical and group health, disability income, Medicare supplement and Medicare Advantage business (with the federal certifications those carry), dental and vision, and long-term care — which comes with a producer credential no other Michigan line requires.
You can license for it alone. Accident & Health Producer (16-66) is 100 questions in 2 hours on 20 hours of pre-licensing; the combined Life, Accident & Health Producer (16-80) is 150 questions in 2.5 hours on 40 hours. Both cost $41.
Worth knowing before you choose: 16-66 carries a 76% cut score, the highest of the seven main producer lines — higher than the combined 16-80 at 75%, and four points above the Life exam. Michigan sets each exam's standard separately, and among the ordinary producer papers the health exam is the least forgiving. (Specialist exams sit higher still: surplus lines is 77% and the counselor papers run to 82%.) That is an argument for preparation, not for avoidance, but it should shape how much time you budget.
If life business is anywhere in your plans, read the Life & Health guide first. Adding the second line later means another 20-hour course and another $41 exam; done together it is one sitting.
Exam Options & Format
Accident & Health Producer, exam code 16-66 — 100 scored questions in 2 hours through PSI, with 1 to 10 unscored experimental items added on top that consume time but not marks.
The cut score is 76%. Michigan publishes a separate cut score for every examination and expresses each as a true percentage of scored items — there is no scaled score here and no flat statewide 70%. DIFS warns that cut scores are subject to change, so check the current figure when you book.
Testing is in person only. DIFS ended remote proctored examinations on 6/10/2025; the last already-scheduled remote sittings ran to 6/30/2025. Seven Michigan test centers remain — the Property guide lists them with addresses.
Book at test-takers.psiexams.com/midifs or on (855) 579-4639. The $41 stays valid a year from payment. Remember Michigan's order: the NIPR application comes first, and it expires 180 days after it reaches DIFS, so the exam has to happen inside that window. The Life guide walks the application.
One practical note about this exam in particular. Michigan's health content is unusually statute-heavy — prompt-pay clocks, external-review deadlines, LTC content mandates — and those are exactly the questions a national course cannot prepare you for. The table below is where the four extra points you need over the Life standard will come from.
Most Tested Topics on the Michigan Accident & Health Exam
Michigan's health content concentrates in three places: the prompt-payment rules at MCL 500.2006, the Patient's Right to Independent Review Act administered by DIFS, and the long-term care content and training mandates. Every row is verified against the source cited:
| Concept | The Michigan rule |
|---|---|
| Clean claim payment deadline | 45 days after the health plan receives the claim — and there is no electronic-versus-paper split. Michigan draws no distinction by submission method anywhere in MCL 500.2006(7) to (14). Note the scope: the prompt-pay scheme runs on claims from health professionals, facilities, home health providers and durable medical equipment suppliers (MCL 500.2006(7), (8)(a)) |
| Interest on a late clean claim | 12% per annum, running once the 45 days expire (MCL 500.2006(8)(a)) |
| Interest on other late claims | A separate and more general rule: 12% simple interest per annum from a date 60 days after satisfactory proof of loss was received (MCL 500.2006(4)) — note the different clock and do not merge the two |
| Deadline to request external review | 120 days from receipt of the notice of adverse or final adverse determination (MCL 550.1911(1)). DIFS publishes the figure as 127 days, adding a seven-day allowance for receipt — so both numbers are real and they measure from slightly different events |
| Internal appeal decision deadlines | 30 days for a pre-service appeal and 60 days post-service, per DIFS's published guidance |
| Expedited external review | Request within 10 days (MCL 550.1913(1)). The independent review organisation reports within 36 hours and the director decides within 24 hours of that (550.1913(8), (10)); DIFS publishes the combined turnaround to consumers as 72 hours |
| Effect of a DIFS external-review order | On a reversal the health carrier immediately shall approve the coverage (MCL 550.1911(19); 550.1913(11) for expedited reviews). DIFS's orders routinely add a duty to submit proof of implementation within 7 days — an order term rather than a statutory one |
| Judicial review of a DIFS order | Circuit court, within 60 days |
| Governmental self-funded plans | Get the same external-review process, under 2006 PA 495 (MCL 550.1951 et seq.) — an unusual extension, since self-funded plans are normally outside state reach |
| State continuation of group coverage | Michigan has none. There is no mini-COBRA statute; DIFS's consumer materials describe federal COBRA only, which attaches at employers with 20 or more employees |
| Long-term care free look | 30 days (DIFS's long-term care publication) |
| Long-term care home-care floor | A policy sold as comprehensive must cover home care at at least half the dollar amount available for nursing-home benefits — so a $100/day nursing-home benefit requires at least $50/day of home care |
| Long-term care inflation protection | The insurer must offer coverage compounding annually at not less than 5%; once the applicant declines it, it need not be offered again |
| Long-term care Partnership policies | Give dollar-for-dollar asset disregard against the Medicaid resource limit |
| Long-term care producer credential | An Accident & Health or Life license, a one-time 8-hour course before selling, soliciting or negotiating LTC, and 4 hours of ongoing training every two-year CE compliance period. DIFS applies it to all producers, resident and non-resident — but training completed in any state satisfies it (MCL 500.1204f(8)), so it is a credential that follows you rather than a second course. The insurer must verify it before letting you sell (MCL 500.1204f(1)(a), (2)(a), (5)) |
| Health insurance marketplace | Federally operated — Michigan runs no state-based exchange, though DIFS certifies qualified health plans and rates alongside the federal government |
The row that costs the most marks is the prompt-pay split that does not exist. Candidates arrive expecting the two-tier structure most states use — a shorter clock for electronic claims, a longer one for paper — and Michigan simply does not have it: 45 days, however the claim arrived. What Michigan does have is a second interest rule that looks similar and is not: MCL 500.2006(4) runs 12% from 60 days after satisfactory proof of loss and applies across lines. Learn them as two rules with two clocks, and read the stem for whether it is a health plan and a clean claim.
The second is continuation. Michigan is a no-mini-COBRA state. A question describing a fifteen-employee firm and asking about the employee's right to continue coverage is testing whether you know that federal COBRA's 20-employee threshold is the only one in play here — there is no state backstop underneath it.
The external-review window is worth learning as two numbers with two sources, because that is how it will appear. MCL 550.1911(1) gives 120 days from receipt of the adverse determination — the statutory answer, and the one to give if a question cites the Patient's Right to Independent Review Act. DIFS publishes 127 days to consumers, adding a seven-day allowance for receipt. Neither is wrong; they measure from slightly different events, and a candidate who knows only the consumer figure will be caught by a statutory question.
Michigan's Background Screen — No Fingerprints, and Why That Raises the Stakes
Michigan does not fingerprint resident producers. MCL 500.1205(1) is written as a closed list — the director shall not approve an application unless the applicant meets all of five conditions: age 18, no act listed in MCL 500.1239(1), the pre-licensing course, the fees, and the examination. There is no sixth condition, and the words fingerprint, criminal history, criminal record and background check do not appear anywhere in MCL Chapter 12.
That does not mean nobody is looking. DIFS says so directly: "DIFS performs several background checks on each applicant." What Michigan has done is replace a fingerprint card with a disclosure obligation — which means the accuracy of your answers, rather than the contents of a database, is what your application turns on.
What the application asks you to disclose. Three categories, each requiring complete details and supporting documentation for any "yes":
- Criminal matters — convictions of any kind, including misdemeanours, felonies, military offences, guilty and no-contest pleas, withheld or deferred judgments, and pending charges. Note how much of that is not a conviction: a deferred judgment you were told would "not go on your record" is still a yes here.
- Administrative actions — censure, suspension, revocation, cancellation, fines, cease-and-desist orders and prohibition orders, from any regulator in any state, insurance or otherwise.
- Child-support arrearage.
Some answers are decided by statute, not by discretion. MCL 500.1205(1)(b) makes approval conditional on the director finding you have not committed an act listed in MCL 500.1239(1), and two of those are mandatory:
- MCL 500.1239(1)(d) — a felony within the 10 years preceding the application. The statute says the director shall not issue the license. There is no weighing exercise.
- MCL 500.1239(1)(e) — regardless of when it happened — a felony involving violence, including domestic violence, criminal sexual conduct, or a breach of fiduciary or financial trust such as fraud, embezzlement, bribery or extortion.
- Other felonies fall under MCL 500.1239(2)(b) and are discretionary — the director may refuse, but is not required to.
The practical consequence is worth stating plainly: a ten-year-old felony that is not on the (1)(e) list becomes a discretionary question the day it passes its tenth anniversary, while an (1)(e) felony never does.
How to handle a disclosure. Answer yes where any doubt exists, and attach the documents rather than a narrative — charging documents, the judgment of sentence, evidence of completion, and any regulator's order. Applications are not usually derailed by the underlying event; they are derailed by a discrepancy between what the applicant reported and what DIFS finds. Since Michigan's screen is disclosure-based, that gap is the only thing the process is really testing.
The duty does not end at licensure. DIFS maintains a standing notification requirement for criminal and administrative violations occurring after you are licensed — report them rather than waiting for a renewal that, in Michigan, never comes.
One last eligibility rule that sits outside the background questions: a person connected with a funeral establishment, mortuary or cemetery may not hold a Michigan insurance license except a limited life license.
What It Costs
$15 to apply through NIPR — $10 to the state under MCL 500.240(1)(d) plus NIPR's $5 — and $41 for the Accident & Health exam. About $56 on a first-time pass, with no fingerprint vendor to pay and no renewal fee afterwards.
The 20-hour pre-licensing course is the substantial cost. If you hold RHU, CEBS, REBC or HIA — the four designations DIFS lists on the health side — or an associate's, bachelor's or master's degree with an insurance concentration, the coursework can be waived entirely. The Life & Health guide owns the waiver rules, including the ordering trap that catches people who book the exam first.
If you intend to sell long-term care, budget for the 8-hour initial training as well. It is not part of the 20 hours and it is required before your first LTC sale — though a resident producer who takes an approved LTC - Partnership course can count those credits toward the 24-hour CE total.
Eligibility Requirements
Be at least 18; have committed no act listed in MCL 500.1239(1); complete 20 hours of approved Accident & Health pre-licensing (or hold an approved waiver); pay the fees; and pass exam 16-66 — the five conditions of MCL 500.1205(1), and there is no sixth.
File the NIPR application before the exam, and watch the 180-day window it opens. The Life guide walks that sequence and the three clocks that run alongside it.
If you already hold a health license elsewhere, MCL 500.1206b may waive both the coursework and the exam where you apply within 90 days of establishing legal residence in Michigan; DIFS runs a three-tier practice around it, covered in the Property & Casualty guide.
Keeping Your License Active
Important CE details: 24 hours every two years including 3 hours of ethics, keyed to a review date on the first day of your birth month. Selling long-term care carries its own credential on top: an 8-hour one-time course before your first LTC sale and 4 hours of ongoing training every two-year CE period, required of resident and non-resident producers alike.
A Michigan resident producer license is perpetual (MCL 500.1206(2)) — no expiry, no renewal application, no renewal fee. What keeps it alive is 24 hours of continuing education every two years, including at least 3 hours of ethics (MCL 500.1204c(2)), completed by a review date falling on the first day of your birth month.
Health producers carry Michigan's only line-specific producer credential. MCL 500.1204f bars you from selling, soliciting or negotiating long-term care insurance unless you hold an Accident & Health or Life license, have completed a one-time 8-hour course, and complete 4 hours of ongoing training every two-year CE compliance period. Two details matter operationally: the requirement reaches non-resident producers as well, which is a real exception to Michigan's otherwise complete CE reciprocity; and the insurer must verify your training before permitting you to sell.
The training is not itself a CE requirement — but a resident producer who takes an approved "LTC - Partnership" course can apply those credits to the 24-hour total, so the same hours do double duty if you choose the course type deliberately.
Miss the review date and MCL 500.1204c(11) starts a 90-day grace period: you may service policies already sold and take commissions on them, but you may not write new business or bind coverage. Still short at day 91 and the director shall cancel the license. The Property & Casualty guide owns renewal, reinstatement, carryover and the rest of the CE machinery.
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