Medical Expense✓ Verified · outline & fact-checked · Sep 2026Difficulty 1/5
Under the Affordable Care Act, insurers selling coverage in the small group market must:
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Answer & full 3-part explanation (select an option above, or peek)
Why A is correct
Guaranteed issue requires small group insurers to accept any eligible employer group that applies, without regard to the health status of the employees or their dependents. Medical underwriting is prohibited for small groups, and coverage must be offered during annual open enrollment and special enrollment periods. This rule, established by the ACA, prevents small employers from being priced out or denied because of an employee's preexisting condition. Rating may still vary by limited factors, but denial of coverage is not permitted.
Why the other options are wrong
- B) Insurers may not reject small employer groups based on claims history; that would violate the guaranteed issue requirement.
- C) Health-status underwriting and medical exams are prohibited in the small group market.
- D) Small group plans must offer comprehensive essential health benefits; they are not limited to catastrophic plans.
Memory hook
Small group = guaranteed in. Health status is off the table when the employer applies.