Mass. Gen. Laws ch. 176A § 3
No non-profit hospital service corporation shall make or issue any contract to provide hospital care and reimbursement for other health services until it has obtained from the commissioner of insurance, in this section called the commissioner, a certificate, in such form as he may prescribe, stating that the corporation has complied with the conditions set forth in this chapter and all other provisions of law authorizing it to make or issue such contract. No such certificate shall be issued until the commissioner is satisfied, by such examination as he may make and such evidence as he may require, that the corporation has complied with the laws of the commonwealth, adopted a proper system of accounting, and employed either full time or on a consulting basis a competent accountant, a competent claim manager, a competent and experienced underwriter, and a competent and experienced actuary; nor, until the commissioner is satisfied, by such examination as he may make and by an affidavit filed with him, and by such evidence as he may require, that the corporation is without liabilities, except such organization expenses as the commissioner shall approve as reasonable; nor until he is satisfied that its officers and directors are of good repute and competent to manage a non-profit hospital service corporation.
Mass. Gen. Laws ch. 176A, § 3