State RegulationsFL specificDifficulty 1/5
In Florida group health insurance, what is a certificate of coverage?
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Answer & full 3-part explanation (select an option above, or peek)
Why C is correct
Under Chapter 627, Florida Statutes, group health insurance is written as a single master policy issued to the group policyholder, and each covered member receives an individual certificate of coverage summarizing the benefits, provisions, and the member's rights under the master policy. The certificate is the member's evidence of coverage and the practical reference for claims. It is not the master contract itself, which remains with the policyholder.
Why the other options are wrong
- A) The master contract is held by the group policyholder; the certificate is the individual member's summary of that coverage.
- B) A certificate of coverage is not a self-insurance license; self-insurance is a separate regulatory matter entirely.
- D) The certificate is given to covered members, not filed as an audit document with the Office of Insurance Regulation.
Memory hook
Master to the group, certificate to the member.