An employer group within New York's small group size range applies to a New York insurer for health coverage. Under New York's community rating requirements, how may the insurer set the group's premium?

Why D is correct

Under the New York Insurance Law's community rating requirements for small groups, coverage is priced by applying the community rate to comparable groups, without regard to any particular group's health status or claims experience. The insurer may not rate up a group for prior claims, medically underwrite individual employees, or negotiate individual deals through the broker, because community rating exists to spread risk across the small-group market and keep coverage available to sicker workforces at a common rate.

Why the other options are wrong

• A) Rating up based on the group's prior claims history is what community rating forbids; the community rate applies regardless of experience.
• B) Medical underwriting of individual employees is inconsistent with community rating; the group is priced as part of a community class.
• C) Individually negotiated rates would defeat community rating; comparable groups must be charged the community rate.

Memory hook

Community rate = same price for comparable groups, claims and health aside.