South Carolina Life and Health Practice Exam

In group health insurance, how is eligibility often determined for coverage?

1. By age and health status

2. By employment hours and duration of service

3. By income level and family status

4. By application date

The correct answer is: By employment hours and duration of service

In group health insurance, eligibility for coverage is primarily determined by employment hours and duration of service. This means that individuals must typically be employed by the company offering the group insurance policy and must meet specific criteria related to their work status. For example, many plans require employees to work a minimum number of hours per week or to have been employed for a certain period before they become eligible for the insurance benefits. This approach ensures that coverage is provided to individuals who are actively contributing to the group, aligning the insurance policy with the overall employment situation of the members. While age, health status, income level, and family status may influence personal health insurance policies or other types of coverage, they are not the primary factors in establishing eligibility for group health insurance. Moreover, the application date is not relevant in group insurance, as eligibility is tied to employment rather than the date when coverage is sought.