Which statement best describes underwriting in group versus individual plans?

Study for the Medical Expense Insurance Exam. Prepare with flashcards and multiple-choice questions; each has hints and explanations. Ace your exam!

Multiple Choice

Which statement best describes underwriting in group versus individual plans?

Explanation:
In group plans, the underwriting approach focuses on the group as a whole rather than each individual. The insurer first evaluates the overall risk of the entire group—looking at factors like average age, industry, and overall claim expectations—and uses that to set base plan terms and premiums. After that, individuals are enrolled and eligibility is determined based on the group's rules, with medical questions or underwriting typically limited or waived during initial enrollment. This is why the best description is that underwriting is performed for the entire group, with individual eligibility determined afterward. The other ideas don’t fit as well. Individual plans price and underwrite on a per-person basis, which is different from the group approach. While some group plans may have simplified or limited underwriting, it is not universally waived for all group plans. And not every plan uses the same underwriting method—group plans often differ from individual plans in how underwriting is applied.

In group plans, the underwriting approach focuses on the group as a whole rather than each individual. The insurer first evaluates the overall risk of the entire group—looking at factors like average age, industry, and overall claim expectations—and uses that to set base plan terms and premiums. After that, individuals are enrolled and eligibility is determined based on the group's rules, with medical questions or underwriting typically limited or waived during initial enrollment. This is why the best description is that underwriting is performed for the entire group, with individual eligibility determined afterward.

The other ideas don’t fit as well. Individual plans price and underwrite on a per-person basis, which is different from the group approach. While some group plans may have simplified or limited underwriting, it is not universally waived for all group plans. And not every plan uses the same underwriting method—group plans often differ from individual plans in how underwriting is applied.

Subscribe

Get the latest from Examzify

You can unsubscribe at any time. Read our privacy policy