Key Takeaways
- Massachusetts has Paid Family and Medical Leave (PFML) program
- PFML provides paid leave for medical and family reasons
- Individual disability policies require standard provisions including grace period
- Long-Term Care Partnership Program provides Medicaid asset protection
- Producers must complete LTC training before selling LTC insurance
Massachusetts Disability and Long-Term Care Insurance
Massachusetts has specific regulations for disability income insurance and long-term care insurance, plus a state-run Paid Family and Medical Leave program.
Paid Family and Medical Leave (PFML)
Massachusetts has a Paid Family and Medical Leave (PFML) program:
- Provides paid leave for medical and family reasons
- Funded through payroll contributions
- Employees and employers share contribution costs
- Administered by the Department of Family and Medical Leave
PFML Benefits
| Leave Type | Maximum Duration |
|---|---|
| Medical Leave | Up to 20 weeks |
| Family Leave | Up to 12 weeks |
| Combined | Up to 26 weeks |
Funding
- Employers and employees contribute
- Self-employed can opt in
- Contribution rates set annually
Private Disability Insurance
Massachusetts also regulates private disability insurance:
Required Policy Provisions
| Provision | Requirement |
|---|---|
| Grace Period | Minimum 31 days for annual premium |
| Reinstatement | Must allow reinstatement within 3 years |
| Notice of Claim | 20 days after loss begins |
| Time to Pay Claims | 30 days after proof of loss |
| Legal Actions | No earlier than 60 days after proof of loss |
Long-Term Care Insurance
Massachusetts has comprehensive LTC insurance regulations:
Free Look Period
- 30-day free look for LTC policies
- Applies to all individual LTC policies
- Policyholder can return for full refund
Required Provisions
| Provision | Requirement |
|---|---|
| Renewability | Must be guaranteed renewable |
| Pre-existing Conditions | Max 6-month look-back typical |
| Elimination Period | Must disclose clearly |
| Inflation Protection | Must offer option |
| Nonforfeiture | Must offer option |
Massachusetts Partnership Program
Massachusetts participates in the Long-Term Care Partnership Program:
How It Works
- Purchase a Partnership-qualified LTC policy
- Use benefits for care
- If benefits exhaust, apply for Medicaid
- Asset protection - Keep assets equal to benefits received
Producer Requirements
To sell LTC insurance in Massachusetts:
- Complete required LTC-specific training
- Complete training before selling
- Ongoing CE requirements
- Must understand Partnership program requirements
Exam Tip: Massachusetts has PFML for paid leave benefits. Private disability and LTC insurance are also regulated with consumer protections.
What state program does Massachusetts have for paid leave?
What is the maximum medical leave duration under Massachusetts PFML?
How long is the free look period for long-term care insurance in Massachusetts?