State RegulationsNY specificDifficulty 1/5
An employee whose group health coverage ended applies within the statutory window for a converted individual health policy. Under N.Y. Ins. Law §3221(e), which statement about issuing the converted policy is correct?
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Answer & full 3-part explanation (select an option above, or peek)
Why A is correct
Under N.Y. Ins. Law §3221(e), a person whose group health coverage ends may convert to individual coverage without evidence of insurability, provided the application is made within 60 days. The insurer cannot re-underwrite the applicant, order a medical examination, or reject the application based on claims history. The statute permits the insurer to offer a group conversion alternative in place of the individual policy, but eligibility itself is guaranteed once the application is timely.
Why the other options are wrong
- B) No medical examination may be required; the conversion privilege exists precisely because no evidence of insurability is needed.
- C) Claims history under the group plan is not a permissible ground to refuse the converted policy; eligibility is guaranteed if the application is timely.
- D) An insurer may offer a group conversion alternative, but that is an option, not a mandatory substitute forced on the applicant.
Memory hook
Conversion = no medical exam, no questions - just apply in time.