State RegulationsNJ specificDifficulty 1/5
In a New Jersey group health arrangement, who is the policyholder under the master contract?
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Answer & full 3-part explanation (select an option above, or peek)
Why D is correct
Group health coverage issued under N.J.S.A. 17B:27-26 et seq. is contracted with the group policyholder — the employer or other eligible group entity that purchases the coverage for its members. The enrolled individuals do not each hold a policy; they receive evidence of their coverage under the master contract. The New Jersey Department of Banking and Insurance regulates this structure but is never itself the policyholder in a private group arrangement.
Why the other options are wrong
- A) Enrolled employees hold coverage through the master contract; they receive certificates, not individual policies, and are not the policyholder.
- B) A treating hospital is a provider of services, not the purchaser of the group contract.
- C) The department regulates group coverage; it does not stand as policyholder in private group arrangements.
Memory hook
One master, one policyholder: the group buys, the members ride along.