Medical Expense✓ Verified · outline & fact-checked · Sep 2026Difficulty 2/5
When underwriting a large group medical plan, the rating is based primarily on:
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Answer & full 3-part explanation (select an option above, or peek)
Why A is correct
Large group underwriting relies on the group's own past claims experience, group size, and the occupational classes represented, because with a large number of covered lives the group's historical utilization is statistically credible. Individual medical histories are not the focus, as they are in individually underwritten coverage. This experience-rating approach is identified in the large group underwriting considerations under AH-III.B.2 of the examination objectives. Because the pool is large, the group's aggregate claim pattern is the most reliable predictor of future cost.
Why the other options are wrong
- B) Individual medical histories matter more in small group or individual underwriting, not for credible large groups.
- C) Rating is not based on a single member's age or gender.
- D) How premiums are paid does not drive the rating of a large group.
Memory hook
Large groups are rated on their own claims track record.