A Texas small employer's plan uses a uniformly applied waiting period before newly hired employees become eligible. An employee who declined coverage when first eligible now asks to enroll. Which statement is correct?

Why A is correct

Under 28 TAC 26.8, a plan may define when enrollment opportunities occur, whether through waiting periods for newly eligible employees, late-enrollment provisions or open-enrollment periods, provided the rules are applied uniformly and never turn on health-status-related factors. So the late enrollee can be held to the plan's regular enrollment mechanics, but the carrier may not use the employee's medical condition to rate the coverage or to block an enrollment the plan rules otherwise allow.

Why the other options are wrong

• B) A prior declination does not permanently bar enrollment under 28 TAC 26.8; the plan's uniformly applied enrollment rules govern.
• C) Retroactive enrollment to the first offer date is not required; the plan may apply its uniform enrollment provisions going forward.
• D) Conditioning enrollment on health-condition rating is exactly the health-status discrimination 28 TAC 26.8 prohibits.

Memory hook

Uniform enrollment rules are fine; health-based ones are not.