State RegulationsFL specificDifficulty 2/5
A Florida small employer that satisfies the plan's enrollment conditions submits a completed application for group health coverage and agrees to pay the premium. Under Florida's guaranteed issue requirement, the carrier:
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Answer & full 3-part explanation (select an option above, or peek)
Why C is correct
Under Chapter 627, Florida Statutes, guaranteed issue means a carrier must accept every small employer group that applies, satisfies the plan's uniformly applied enrollment conditions, and tenders the premium. The carrier cannot sift through the employees' medical histories to decide whether the group is worth taking, which is the central protection that keeps small businesses from being uninsurable in the group market.
Why the other options are wrong
- A) Reviewing medical histories to reject the group is exactly the underwriting practice guaranteed issue abolishes for small employers.
- B) Guaranteed issue is issue of the actual coverage; carving benefits down per employee is not a lawful substitute.
- D) Referral to another carrier is not a substitute for the carrier's own duty to issue coverage to a qualifying group.
Memory hook
Qualifying small employer applies, carrier issues. Period.