Review Standards for Basicl Medical Insurance for Group Commerical Insurers Subject to Article 32 2025

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(1) The members eligible for insurance under the policy shall be all of the members of the union or all of any class or classes thereof determined by conditions pertaining to their employment or to membership in the union, or both.
An employer can cover any employee who is on the payroll and for whom he or she pays payroll taxes. Eligible employees generally include those who are on paid vacation, maternity or sick leave.
A mandatory minimum group size spreads the risk and administrative costs over numerous participants. A companys group health plan specifies that if the insured is eligible for benefits under another policy, the plan will be the primary plan.
Expert-Verified. An insurance company can offer group health insurance for businesses with a certain number of employees, which allows for risk balancing among insured individuals. The correct answer is c) Only for businesses with a certain number of employees.
Typically, an employee is only eligible for Group Health coverage if the employee is working full-time. If an employees job is cut to part-time, or if theyve always worked part-time, their coverage can be denied or even canceled going back to when their employment status changed to less than full-time.
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Group insurance is typically offered through employers and provides coverage to a group of employees, while individual insurance is purchased by individuals directly from insurance providers, offering personalized coverage outside of employer-sponsored plans.

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