Medical Expense✓ Verified · outline & fact-checked · Sep 2026Difficulty 1/5
In a group medical expense policy, which document is issued to each covered employee describing the benefits and exceptions of the plan?
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Answer & full 3-part explanation (select an option above, or peek)
Why B is correct
Group insurance is structured under a single master policy issued to the employer or trustee, who is the master policyholder. Each covered employee does not receive the master contract; instead the employee receives an individual certificate of coverage that summarizes the benefits, limitations, exceptions, and conditions of the group plan. The certificate incorporates by reference the master policy and must be approved by the commissioner before it is issued.
Why the other options are wrong
- A) The master policy is issued to and held by the employer or trustee, not delivered to each covered employee.
- C) A binder is temporary evidence of insurance pending issuance of a policy; it is not used to describe ongoing group benefits.
- D) The premium notice is a billing document, not a description of the employee's benefits and exceptions.
Memory hook
Master policy = the boss's contract. Certificate = the employee's summary of what is covered.