State RegulationsNC specificDifficulty 2/5
A Durham worker's group hospital coverage has terminated and she did not continue it. To obtain an individual converted policy under G.S. 58-53-45 and G.S. 58-53-55, what must she do?
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Answer & full 3-part explanation (select an option above, or peek)
Why D is correct
Under G.S. 58-53-45, an employee or member whose group coverage terminates is entitled to an individual converted policy without evidence of insurability. Under G.S. 58-53-55, the written application and the first premium must be submitted no later than 31 days after the group coverage terminates, and the converted policy takes effect the day after the later of the end of the 31-day window or the end of any continuation period.
Why the other options are wrong
- A) No evidence of insurability may be required for conversion, and 60 days is the continuation election window, not the conversion deadline.
- B) 18 months is the continuation maximum; the conversion application deadline is 31 days, and insurability is not required.
- C) The 31-day deadline is correct, but the statute forbids conditioning the converted policy on a medical examination or any evidence of insurability.
Memory hook
Convert in 31 days with no health questions asked.