State RegulationsFL specificDifficulty 2/5
A newly hired employee becomes eligible for her company's Florida group health plan. What document evidences her coverage?
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Answer & full 3-part explanation (select an option above, or peek)
Why A is correct
When an employee becomes eligible for group health coverage, her coverage is evidenced by an individual certificate of coverage issued under the group master policy held by the employer. Under Chapter 627, Florida Statutes, group members are covered without separate individual underwriting, so no new individually underwritten policy is issued. The certificate tells her what benefits she has and how to use them from day one.
Why the other options are wrong
- B) Group members are covered under the master policy without a separately underwritten individual policy.
- C) The Department of Financial Services does not issue coverage binders; the insurer issues the certificate under the group contract.
- D) Written evidence of coverage exists from eligibility; the member does not have to wait for a claim to receive her certificate.
Memory hook
Join the group, get the certificate.