State RegulationsMA specificDifficulty 2/5
A Massachusetts resident's major medical coverage was issued by an insurer that later fails. Under M.G.L. c. 175, § 146B, which tier of health-benefit protection applies to basic hospital, basic medical-surgical, and major medical coverage?
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Answer & full 3-part explanation (select an option above, or peek)
Why A is correct
M.G.L. c. 175, § 146B(3)(b)(ii) sets health-benefit protection in tiers, and the highest tier — $500,000 per individual — covers basic hospital, basic medical-surgical, and major medical benefits. The Massachusetts Life and Health Insurance Guaranty Association applies the lower tiers to disability income, long-term care, and other health coverage. Identifying which coverage sits in which tier is the testable skill.
Why the other options are wrong
- B) $300,000 is the tier for disability income and for long-term care coverage under M.G.L. c. 175, § 146B(3)(b)(ii), not the major medical tier.
- C) $100,000 is the tier for health coverage not defined as disability income, basic hospital, basic medical-surgical, major medical, or long-term care under M.G.L. c. 175, § 146B(3)(b)(ii).
- D) $250,000 is the annuity present-value cap under M.G.L. c. 175, § 146B(3)(b)(iii), not a health-benefit tier.
Memory hook
Major medical rides the top tier: $500,000.