After a member's group health coverage under a North Carolina group policy terminates, he wants an individual policy under the conversion privilege. What does the conversion right provide?

Why A is correct

Under G.S. 58-53-45, an employee or member whose group coverage terminates is entitled to a converted individual policy without evidence of insurability. Under G.S. 58-53-55, the written application and first premium must be submitted no later than 31 days after termination of group coverage, and the converted policy takes effect the day after the later of the end of the 31-day window without replacement or the end of the continuation period.

Why the other options are wrong

• B) Conversion requires no evidence of insurability and no medical examination under G.S. 58-53-45, and the statutory deadline is 31 days, not 60.
• C) The conversion right is a statutory entitlement under G.S. 58-53-45 with a firm 31-day application deadline under G.S. 58-53-55; it is not left to insurer discretion.
• D) 10 days is the hospitalization return-right figure under G.S. 58-51-10; the conversion application deadline is 31 days under G.S. 58-53-55.

Memory hook

Convert with no medical questions, but apply and pay within 31 days.

Why B is correct

G.S. 58-53-45 entitles the terminated employee or member to a converted individual policy without evidence of insurability, and G.S. 58-53-55 requires the written application and first premium no later than 31 days after the group coverage terminates. The converted policy takes effect the day after the later of the missed 31-day point or the end of the continuation period.

Why the other options are wrong

• A) Sixty days is the continuation election window under G.S. 58-53-10, and conversion under G.S. 58-53-45 requires no evidence of insurability.
• C) No medical examination or other evidence of insurability may be required for conversion; G.S. 58-53-45 grants the right without it.
• D) The conversion deadline is 31 days under G.S. 58-53-55; 180 days is the A&H proof-of-loss period under G.S. 58-51-15(a)(7).

Memory hook

Convert in 31 days, no health questions asked.

Why C is correct

Under G.S. 58-53-55, the written application and the first premium for the converted policy must be submitted no later than 31 days after termination of the group coverage, and under G.S. 58-53-45 the conversion is available without evidence of insurability. The converted policy takes effect the day after the later of (i) the group termination not replaced within 31 days, or (ii) the end of any continuation period actually elected.

Why the other options are wrong

• A: 10 days is the standard free-look return period (G.S. 58-51-10; 11 NCAC 12 .0447), not the conversion application deadline.
• B: 60 days is the minimum continuation election window under G.S. 58-53-10; the conversion application itself is due within 31 days (G.S. 58-53-55).
• D: 180 days belongs to the proof-of-loss and claim-filing windows (G.S. 58-51-15(a)(7); G.S. 58-3-225(f)), not the conversion deadline.

Memory hook

Convert in 31 days, no medical exam.