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Group Accident & Health (L&A/H)

Characteristics and Marketing

Group Contract
Certificate of Coverage
Contributory vs. Non-Contributory
Experience Rating vs. Community Rating
Regulatory Jurisdiction

Types of Eligible Groups

Eligible Groups
Employment-Related Groups
Associations
Customer Groups
Discretionary Groups
Funding and Administration

Employer Group Health

Insurer Underwriting Criteria
Eligibility for Insurance
Annual Open Enrollment
Conversion Rights
Probation Period
Coordination of Benefits (COB)
Change or Loss of Coverage
Reinstatement for Military

COBRA

What is COBRA?
Eligibility
Duration of Coverage
Premium
Utah Mini-COBRA

Small Employer Plans

Definition of Small Employer
Availability of Coverage
Rating Small Employer Plans
Pre-Existing Conditions
Participation Requirements
Surcharge for Changing Carriers
Open Enrollment

Regulation of Employer Plans

ERISA
Age Discrimination (ADEA)
Civil Rights and Pregnancy Act
Relationship with Medicare
Nondiscrimination Rules

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