Medical Expense✓ Verified · outline & fact-checked · Sep 2026Difficulty 2/5
Under the guaranteed issue requirement, a small employer health plan insurer must:
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Answer & full 3-part explanation (select an option above, or peek)
Why A is correct
Guaranteed issue requires insurers in the individual and small group markets to accept all applicants without regard to health status, pre-existing conditions, or claims experience. A small employer cannot be turned down for coverage because of the health of its employees. This protection, part of the PPACA and small group rules under AH-III.B.3, prevents medical underwriting from barring access to group health insurance. Acceptance is unconditional on health, although premiums may still vary with permitted rating factors.
Why the other options are wrong
- B) Guaranteed issue means health status is not used to deny coverage, so individual medical reviews are not the basis for acceptance.
- C) Poor claims experience is precisely what guaranteed issue prevents from blocking coverage.
- D) Guaranteed issue concerns acceptance, not a promise that premiums will never rise.
Memory hook
Guaranteed issue = every small group gets in, health status aside.