Under the guaranteed issue requirements of the ACA, health insurers offering individual coverage must:
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Answer & full 3-part explanation (select an option above, or peek)
Why A is correct
Guaranteed issue requires health insurers to accept every applicant for individual and small group coverage, without regard to health status, medical history, or genetic information. Insurers may not turn down an applicant or charge a higher premium because of illness or claims history. Premiums in the individual and small group market may vary only based on limited rating factors, such as age, tobacco use, geographic area, and family size, not health. Guaranteed issue is one of the ACA's core consumer protections and works together with the ban on preexisting condition exclusions.
Why the other options are wrong
- B) Open enrollment limits when coverage can be purchased, but guaranteed issue separately requires acceptance of anyone who does enroll.
- C) Rejecting applicants because of preexisting conditions directly violates the ACA's guaranteed issue rule and the ban on preexisting exclusions.
- D) Premiums may not be based on health status or chronic illness under the ACA's adjusted community rating rules.
Memory hook
Guaranteed issue = nobody gets turned down for being sick. Health status is off the table.