State RegulationsNC specificDifficulty 3/5
The guaranty association covers two individuals: one under a policy qualifying as a health benefit plan, and one under covered health coverage that is not defined as a health benefit plan. What limits apply under G.S. 58-62-21?
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Answer & full 3-part explanation (select an option above, or peek)
Why B is correct
Under G.S. 58-62-21(d)(2a), health benefits are capped at $300,000 for coverages not defined as health benefit plans and at $500,000 for coverages that are health benefit plans. Matching the higher tier to the plan classification is the key step in computing guaranty protection for health coverage.
Why the other options are wrong
- A) A flat $300,000 ignores the enhanced $500,000 limit that G.S. 58-62-21(d)(2a) grants to health benefit plans.
- C) This reverses the tiers; the higher $500,000 cap belongs to health benefit plans, not to other covered health coverage.
- D) The $1,000,000 figure is the structured settlement limit under G.S. 58-62-21(d)(5) and has no application to health coverage.
Memory hook
Health benefit plan gets half a million; other health coverage gets three hundred grand.