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12 Cards in this Set

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Employees really responsible for paying 75% of eligible employees.


-Employer pays the entire premium

-Participation must include 100% of eligible employees.

Community Rating

A process that is typically used to determine premiums for individual health.

Experience Rating

A process that is typically used to determine premiums for group health insurance.

Probationary Period

Length of time a new employee must wait before becoming eligible to participate in the group insurance plan.

Eligibility Period

-Begins when the probationary Period ends.

-Late enrollments may be required to provide evidence of insurability.

Open Enrollment Period

●The only time an employee may make changes to the insurance benefits.

•Change in number of dependents

-marriage, divorce, birth, death, adoption

•Change in employment status

-Employee moves from full-time to part-time

No loss, no gain

- No new probationary periods or preexisting condition limitations can be imposed by the new insurer.

- The new insurer must accept the group exactly as they were with the old insurer.


Applies to employees who lose eligibility for health insurance coverage for any reason except gross misconduct.

Notification Period

A qualified beneficiary must be notified in writing of the right to continue coverage within 14 days of the qualifying event.

Decision Period

A qualified beneficiary has 60 days from receiving written notice of the right to continue to make a decision about whether or not to continue coverage.

Continuation Period

A qualified beneficiary may continue to participate in the group insurance plan by paying 102% of the actual group rate to the pan sponsor.