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State RegulationsNY specificDifficulty 3/5

A trade association applies for small employer medical coverage in New York on behalf of its member employers. Under Reg 145, how is small employer status evaluated for association coverage?

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Answer & full 3-part explanation (select an option above, or peek)

Why B is correct

Under Reg 145 (11 NYCRR Part 360), small employer status for association business is determined group by group: each association member group must have no more than 50 employees. Measuring each member group separately keeps the small group protections tied to genuinely small employers rather than to large employers pooling through an association.

Why the other options are wrong

  • A) The test does not run on the association's aggregate headcount, which would mix large and small employers into one measurement.
  • C) Every member group is measured, not just the largest one; smaller groups are not automatically treated as small.
  • D) Association membership does not open the small employer market to member groups that exceed the employee ceiling.

Memory hook

Association coverage: judge each member group on its own headcount.

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