What features differentiate individual health insurance from group plans?

• A. Eligibility criteria are the same for both; underwriting differs.
• B. Group plans typically require medical underwriting of the entire workforce.
• C. Eligibility, underwriting, premium rates, coverage options, and conversion rights; group plans usually have employer sponsorship and group underwriting.
• D. Conversion rights do not apply to group plans.

Answer: (C)

The main idea is that individual and group health insurance differ across who is eligible, how risk is assessed, how premiums are set, what benefits are offered, and what happens when you leave the plan.

In individual plans, you apply on your own and underwriting determines whether you’re accepted and what premium you pay based on your personal health and other factors. In group plans, eligibility comes from being part of the employer’s group, with enrollment often automatic for qualifying employees, and the pricing is set for the entire group rather than for each person. Coverage options tend to be standardized within the group plan, and there’s typically employer sponsorship along with some form of group underwriting, rather than individual underwriting for everyone.

Conversion rights are another important difference: group plans generally allow you to convert to an individual policy when you leave the employer or lose eligibility, usually without needing to prove insurability, though subject to plan-specific rules and time limits.

So the statement that lists eligibility, underwriting, premium rates, coverage options, and conversion rights, plus the idea that group plans are usually employer-sponsored with group underwriting, best captures the distinguishing features. The other choices misstate eligibility, understate how group plans work, or deny conversion rights.