State RegulationsCO specificDifficulty 2/5
A Colorado carrier's small-employer group policy uses the term 'participation' in a way that conflicts with state law. Which authority controls the meaning of defined small-group terms such as 'small employer,' 'eligible employee,' and 'participation'?
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Answer & full 3-part explanation (select an option above, or peek)
Why A is correct
The controlling definitions for the Colorado small-employer market are set by statute in C.R.S. § 10-16-102 and implemented through Colorado Division of Insurance rules such as Reg. 4-6-8. A policy term that conflicts with those definitions cannot be enforced as written, so carriers must draft and producers must explain small-group coverage using the statutory meanings.
Why the other options are wrong
- B) A carrier manual cannot override the statutory definitions; the statute and the Division's rules control.
- C) Appointment records establish licensing status, not the meaning of coverage terms.
- D) An employer handbook is a workplace document with no authority over insurance definitions.
Memory hook
Definitions live in the statute — the manual just follows.