PassSprint
State RegulationsTX specificDifficulty 2/5

In a Texas employer group life plan, an employee declines coverage during the initial eligibility period and then enrolls a year later. Under Texas group underwriting rules, what is the insurer's position on evidence of insurability for that employee?

Select an option to reveal the answer and the full 3-part explanation — free, no signup.

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

Why B is correct

Under TIC 1131.053, group life is underwritten on the group as a whole: the insurer evaluates the group's characteristics and normally covers members who enroll during the eligibility period without individual evidence, but it may require evidence of insurability from a person who applies after that window closes, in order to guard against adverse selection. The practical consequence is that agents should stress the enrollment deadline, because missing it can mean a medical review, a reduced amount, or a declined application.

Why the other options are wrong

  • A) The insurer may require evidence in defined circumstances, most notably on late enrollment.
  • C) Requiring evidence from every member would contradict the group mechanism of underwriting the group as a whole.
  • D) Group underwriting is not individual underwriting of every member; timely enrollees are routinely covered without evidence.

Memory hook

Enroll on time and skip the exam; enroll late and earn it.

Related Practice Questions