State RegulationsNJ specificDifficulty 2/5
How does eligibility for a New Jersey group health plan primarily attach to covered persons?
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Answer & full 3-part explanation (select an option above, or peek)
Why B is correct
Group health coverage under N.J.S.A. 17B:27-26 et seq. insures the group as a whole: eligibility flows from membership in the eligible group, such as active employment with the group policyholder, as the master contract defines it. Individual medical underwriting of each member is not the organizing mechanism, which is what distinguishes group from individually underwritten coverage. The New Jersey Department of Banking and Insurance supervises how carriers define and administer group eligibility.
Why the other options are wrong
- A) Individual medical underwriting is the hallmark of individual coverage; group eligibility attaches through group membership instead.
- C) No state-issued eligibility card exists in the group framework; eligibility is defined by the master contract, not by departmental issuance.
- D) Credit standing plays no role in group health eligibility; the master contract's group-membership definition controls.
Memory hook
Join the group, get the coverage: membership, not medical exam.