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State RegulationsNC specificDifficulty 3/5

A Durham employee covered under her employer's group hospital policy for five consecutive months loses eligibility for group coverage. Which statement about electing North Carolina continuation coverage is correct?

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Answer & full 3-part explanation (select an option above, or peek)

Why D is correct

Under G.S. 58-53-10, an employee continuously insured under the group policy for the 3 consecutive months immediately before termination is eligible; her five months of coverage qualify. She may elect continuation for a period of not fewer than 60 days after termination or loss of eligibility, the first contribution is due upon election, and the continued coverage is retroactive to the date coverage terminated.

Why the other options are wrong

  • A) The election window is at least 60 days under G.S. 58-53-10, not 10 days, and coverage is retroactive to termination rather than beginning when the first contribution is received.
  • B) Eligibility requires 3 consecutive months of coverage immediately before termination under G.S. 58-53-10, not 12; her five months satisfy the rule.
  • C) The election period is fixed at not fewer than 60 days after termination; election is not available at any arbitrary later point, and coverage runs from the termination date, not the election date.

Memory hook

Three months insured, sixty days to elect, coverage reaches back to termination.

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