State RegulationsCA specific✓ Verified · outline & fact-checked · Sep 2026Difficulty 3/5
Under California Insurance Code Section 10192.12, an individual who loses employer-sponsored group coverage, such as retiree health benefits, generally has a guaranteed issue right to:
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Answer & full 3-part explanation (select an option above, or peek)
Why A is correct
Section 10192.12 gives Medigap guaranteed issue rights to individuals who lose specified types of coverage, including employer-sponsored or retiree group health coverage, by allowing them to purchase a Medigap policy without medical underwriting during a limited window. This protection prevents a gap in coverage when transitioning from group coverage to Medicare. The guaranteed issue right is distinct from open enrollment because it applies in specific triggering situations rather than to all new Part B enrollees. It is examined under AH-III.D.1e.
Why the other options are wrong
- B) Guaranteed issue applies to Medigap policies, not to Part D premiums, which are separate.
- C) Medigap is a supplemental policy, not a conversion of the group plan into individual major medical.
- D) The statute provides an insurance purchasing right, not any pension or cash benefit.
Memory hook
Lost group coverage? Guaranteed issue says insurers must still sell you Medigap.