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Group Health Insurance Standards Model Act
Edition and licensing notes
Publisher. National Association of Insurance Commissioners (NAIC)
Status. NAIC model, © NAIC. Brief quotations under fair use; not the enacted law of any state until adopted.
What this document is
Group Health Insurance Standards Model Act is a naic model law published by National Association of Insurance Commissioners (NAIC). It is one of the documents that insurance license exam questions are written from, including life & health practice questions. This page summarizes it and points to the official version, which is the text to rely on.
Sections cited in practice questions
Each practice answer shows the exact passage it comes from. These are sections of this document that questions cite, with a short excerpt from the source text.
- NAIC Model #100: Section 3 (Definitions)
““Evidence of individual insurability” means medical information, or other information that indicates health status, used to determine whether coverage of an individual within the group is to be limited or excluded.”
- NAIC Model #100: Section 6 (Notice of Compensation)
““sponsoring or endorsing entity” means an organization that has arranged for the offering of a plan of insurance in a manner that communicates that eligibility for participation in the plan is dependent upon affiliation with the organization or that it encourages participation in the plan.”
- NAIC Model #100: Section 4 (Eligible Groups)
“which employer or trustees shall be deemed the policyholder, to insure employees of the employer for the benefit of persons other than the employer, subject to the following requirements:”
- NAIC Model 100: Section 7 (Dependent Group Health Insurance)
“Except for a policy issued under Section 4B of this Act, a group health insurance policy may be extended to insure the family members and dependents of the employees or members , or any class or classes thereof, if:”
- NAIC Group Health Insurance Standards Model Act § 4E(6) (association member solicitation and disapproval)
“In determining whether an association meets the standards set forth in this subsection, the commissioner shall consider whether the association’s primary method of obtaining new members is not through, or in conjunction with, the solicitation of insurance. (b) If the commissioner determines that an...”
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