State RegulationsCA specific✓ Verified · outline & fact-checked · Sep 2026Difficulty 1/5
In the small-group health insurance market in California, 'guaranteed issue' means:
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Answer & full 3-part explanation (select an option above, or peek)
Why A is correct
Under the ACA and California law, insurers must accept every small employer group that applies, regardless of employee health status, and may not exclude individuals based on health. Guaranteed issue applies to all new group and individual health plans. Small groups cannot be rejected because a particular employee is sick, though premiums may still vary within permitted limits by factors such as age, geography, tobacco use, and plan design.
Why the other options are wrong
- B) Declining a group because of employees' health status is exactly what guaranteed issue prohibits.
- C) Guaranteed issue protects eligible groups of all sizes; there is no 25-employee threshold for acceptance.
- D) Rate guarantees are not part of guaranteed issue; premiums may change at renewal within statutory limits.
Memory hook
Guaranteed issue = every small employer is in, no matter how sick the workforce.