During the Medigap open enrollment period under California law, an insurer:

Why A is correct

California's Medigap open enrollment period under CIC Section 10192.11(a) gives a qualifying applicant guaranteed issue: for an application submitted during the six-month window beginning with the first month the individual is both 65 or older and enrolled in Medicare Part B, the issuer may not deny or condition the issuance of the policy, nor discriminate in its pricing, because of the applicant's health status, claims experience, receipt of health care, or medical condition. Guaranteed issue does not eliminate every preexisting-condition consequence, however. Under Section 10192.11(c), the issuer may still exclude benefits for a preexisting condition during the first six months if it was treated or diagnosed within the six months before coverage began, unless Section 10192.11(b) applies: with at least six months of continuous creditable coverage, the exclusion cannot be imposed at all, and with less, it must be reduced by the creditable coverage. After the open enrollment window closes, medical underwriting generally returns for most applicants.

Why the other options are wrong

• B) During open enrollment an issuer cannot reject the applicant or medically underwrite the policy; a preexisting condition can result only in a limited waiting period of up to six months, reduced or eliminated by creditable coverage - never an outright rejection.
• C) Discriminating in the price of a policy because of health status, claims experience, receipt of health care, or medical condition is expressly prohibited during the open enrollment period.
• D) A Medigap policy is guaranteed renewable; the issuer cannot cancel it merely because claims exceeded premiums, so this option confuses renewability with rescission.

Memory hook

Medigap open enrollment = the take-me-as-I-am window: no medical questions, no denials, guaranteed issue.