A group member whose employment terminated elects continuation coverage 45 days after the termination date and pays the first required contribution at that time. Under North Carolina law, the continued coverage takes effect:

Why D is correct

Under G.S. 58-53-10, a covered person may elect continuation for a period of not fewer than 60 days after termination of the group coverage, with the first contribution due upon election, and the continued coverage is retroactive to the date the group coverage terminated. Electing at 45 days is within the election window, and payment then relates back — the intervening gap is bridged rather than excluded. No insurer approval is a condition of the statutory right.

Why the other options are wrong

• A: There is no first-of-the-month restart rule; the statute ties the effective date to the termination date of the group coverage (G.S. 58-53-10).
• B: Insurer approval is not a condition of the statutory continuation right; election plus the first contribution takes effect retroactively (G.S. 58-53-10).
• C: Making the election date the effective date would strip away the retroactive feature that G.S. 58-53-10 grants; coverage relates back to the termination date.

Memory hook

Elect within 60 days, pay once, coverage jumps back to termination day.