A group long-term care certificateholder's coverage ends because the master group policy terminates. Under 31 Pa. Code 89a.105, what must be available to the certificateholder?
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Answer & full 3-part explanation (select an option above, or peek)
Why B is correct
Pennsylvania's continuation and conversion rule for long-term care, 31 Pa. Code 89a.105, ensures that when group long-term care coverage terminates — whether the master policy ends or the individual's membership ceases — the certificateholder has rights of continuation or conversion rather than a bare loss of coverage. The rule keeps long-term care protection, which is bought against the risk of future need, from evaporating through events the certificateholder does not control. The Pennsylvania Insurance Department treats these rights as a required feature of group long-term care arrangements.
Why the other options are wrong
- A) Outright forfeiture is what 31 Pa. Code 89a.105 exists to prevent; termination of the group arrangement triggers rights, not a wipeout.
- C) Long-term care coverage continues or converts into long-term care protection; it does not become a Medicare supplement policy, which is a different product governed by different rules.
- D) The rule provides continuation or conversion of coverage, not a disgorgement of all premiums ever paid.
Memory hook
Group ends, coverage doesn't: continue or convert, never just cancel.