State RegulationsTX specificDifficulty 2/5
A Texas small employer health benefit plan issuer may not do which of the following?
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Answer & full 3-part explanation (select an option above, or peek)
Why D is correct
Under TIC Chapter 1501, the Texas small employer market is built on guaranteed availability: an issuer may not turn a group away, or refuse to keep it, because its employees are in poor health or have generated claims. The chapter leaves the issuer its normal enrollment mechanics - employer contribution and minimum participation requirements remain ordinary features of group coverage - and it regulates preexisting condition limitations rather than eliminating the issuer's ability to apply them in accordance with the chapter.
Why the other options are wrong
- A) Requiring an employer contribution is ordinary group underwriting and is not prohibited by the chapter.
- B) A minimum participation requirement is a normal enrollment condition, not the health-status discrimination the chapter bars.
- C) Applying the chapter's own preexisting condition rules is permitted; refusing to issue or renew because of employee health status is not.
Memory hook
In the Texas small group market you cannot underwrite the group's health.