State RegulationsVA specificDifficulty 2/5
An employer sponsors a group health plan in Virginia. An employee asks why he received only a summary booklet while the 'real' policy went to human resources. Under Va. Code § 38.2-3533, how do you explain the arrangement?
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Answer & full 3-part explanation (select an option above, or peek)
Why C is correct
Va. Code § 38.2-3533 structures group coverage documentation exactly as the employee observed: the master contract is delivered to the contract holder — here, the employer — and each covered person is furnished a certificate describing the coverage, its benefits, and its limitations. The certificate is not optional marketing; it is the member's statutory summary of the protection under Virginia law. Explaining this division reassures the employee that the booklet is his evidence of coverage, while the policy itself resides with the group.
Why the other options are wrong
- A) The employer is not withholding anything; Va. Code § 38.2-3533 places the master contract with the contract holder and the certificate with the member.
- B) The certificate is a statutory document right under Va. Code § 38.2-3533, not optional marketing material.
- D) The certificate comes through the insurer and the contract holder under the group framework; the Commission is the regulator, not the document distributor.
Memory hook
Employer keeps the contract; the certificate is the employee's proof.