State RegulationsGA specificDifficulty 2/5
A covered person in Columbus, Georgia holds coverage under a health benefit plan issued by an insolvent insurer. What is the maximum obligation of the Georgia Life and Health Insurance Guaranty Association for that individual's health benefit plan coverage?
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Answer & full 3-part explanation (select an option above, or peek)
Why D is correct
Under O.C.G.A. § 33-38-7(a)(12)(B)(ii) and (D)(i), ordinary health categories — disability income, long-term care, and other health insurance including cash values — are capped at $300,000, but coverage under a HEALTH BENEFIT PLAN carries a higher maximum of $500,000 per individual. This is the one place the aggregate cap rises above $300,000 in the guaranty scheme.
Why the other options are wrong
- A) $300,000 is the cap for disability income, long-term care and other health insurance under O.C.G.A. § 33-38-7(a)(12)(B)(ii), but a health benefit plan gets the elevated $500,000 limit.
- B) $250,000 is the net cash surrender cap for ANNUITIES under O.C.G.A. § 33-38-7(a)(12)(B)(iii); it has no application to health benefit plan coverage.
- C) $100,000 caps the cash surrender value of life insurance under O.C.G.A. § 33-38-7(a)(12)(B)(i); it is not the limit for a health benefit plan.
Memory hook
Health benefit plans are the VIP row of the Georgia guaranty scheme — half a million while the rest sit at three hundred.