State RegulationsNJ specificDifficulty 3/5
Which statement best distinguishes a New Jersey individual health policy from a group health policy?
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Answer & full 3-part explanation (select an option above, or peek)
Why B is correct
The structural distinction is contractual. An individual health policy is issued directly to the insured person — the market governed by New Jersey's Individual Health Coverage Program framework beginning at N.J.S.A. 17B:27A-1 — while a group policy under N.J.S.A. 17B:27-26 et seq. is issued to a group policyholder whose enrolled members receive certificates. The New Jersey Department of Banking and Insurance regulates both markets; neither is unregulated, and both individual and group coverage operate with the consumer protections New Jersey law provides.
Why the other options are wrong
- A) The markets run the opposite way: individual policies go to persons buying for themselves, and group policies go to employers and other group entities.
- C) Both markets are regulated; group health business is supervised under N.J.S.A. 17B:27-26 et seq. just as individual business is under its own framework.
- D) Individual health policies do contain grace periods under New Jersey law, so the stated contrast is false on both ends.
Memory hook
Individual = contract in your name; group = contract in the employer's name, certificate in yours.