State RegulationsNY specificDifficulty 1/5
A member of a group health plan in Yonkers leaves the group and applies for a converted individual policy during the conversion period. What may the insurer require of the applicant regarding insurability?
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Answer & full 3-part explanation (select an option above, or peek)
Why B is correct
Under N.Y. Ins. Law §3221(e), an insured whose group health coverage terminates has the right to convert to an individual policy without evidence of insurability. No medical examination, no statement of health, and no claims-history review may be imposed. The conversion right is a statutory protection designed so that people leaving group coverage cannot be shut out of individual coverage because of their health.
Why the other options are wrong
- A) A medical examination is evidence of insurability, and §3221(e) prohibits requiring it as a condition of conversion.
- C) A physician's statement of good health is equally an evidence-of-insurability requirement barred by the statute.
- D) Claims history cannot condition the conversion right; the converted policy must be offered regardless of the applicant's health status.
Memory hook
No exams, no proof, no questions: group health conversion is issued as of right.