State RegulationsNC specificDifficulty 2/5
An employee whose group health coverage has terminated seeks to convert to an individual policy without evidence of insurability. What does North Carolina law require?
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Answer & full 3-part explanation (select an option above, or peek)
Why B is correct
Under G.S. 58-53-45, the employee or member is entitled to a converted individual policy without evidence of insurability, and under G.S. 58-53-55 the written application and first premium are due no later than 31 days after the group coverage terminates. The converted policy takes effect the day after the later of the end of the continuation period or an unreplaced termination.
Why the other options are wrong
- A) The 3-consecutive-month test is the eligibility requirement for continuation under G.S. 58-53-10, not a precondition for conversion.
- C) G.S. 58-53-85 forbids the converted policy from excluding as preexisting any condition the group policy covered.
- D) No 60-day waiting period applies; the effective date follows the rule of G.S. 58-53-55, keyed to termination and continuation.
Memory hook
Convert within 31 days of losing group coverage - no medical questions asked.