State RegulationsFL specificDifficulty 3/5
An employee asks her Florida agent which rules apply to her employer's NON-grandfathered group health plan. Which statement is correct?
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Answer & full 3-part explanation (select an option above, or peek)
Why D is correct
A non-grandfathered plan is one that does not qualify for grandfathered status, so it must comply with every current minimum benefit standard. Under the standards reflected in Chapter 627, Florida Statutes, and enforced by the Florida Office of Insurance Regulation, non-grandfathered plans cannot impose lifetime dollar limits on essential health benefits and cannot keep pre-reform provisions that grandfathered plans are permitted to retain. Group issuance does not exempt the policy from Florida's minimum benefit standards.
Why the other options are wrong
- A) Only grandfathered plans may retain pre-reform provisions; non-grandfathered plans must meet all current standards.
- B) Lifetime dollar limits on essential health benefits are prohibited for non-grandfathered plans regardless of group issuance.
- C) Group health policies delivered in Florida remain subject to the state's minimum benefit standards; group status is not an exemption.
Memory hook
No grandfather, no exceptions — current standards apply in full.