Question

The provision in a group health policy that allows the insurer to post phone coverage for a covert illness 30 days after the policy's effective date is referred to as the

A) Pre-existing condition clause.
B) Waiting period clause.
C) Grace period clause.
D) Exclusionary clause.

Answer 1

The correct answer is the Waiting period clause, which allows insurers to postpone coverage for a certain time after the policy's start date. This is distinct from a Pre-existing condition clause, which was commonly used prior to the ACA to deny coverage based on existing illnesses.

Step-by-step explanation:

The provision in a group health policy that allows the insurer to postpone coverage for a covered illness 30 days after the policy's effective date is known as the Waiting period clause. This clause is different from the Pre-existing condition clause, which refers to a provision that allows insurers to exclude coverage for illnesses or conditions that existed prior to the policy's effective date. Health insurance plans had used the pre-existing condition clause to deny enrollment to individuals with chronic diseases before the implementation of the Patient Protection and Affordable Care Act (ACA) or Obamacare in 2010, which reformed the insurance market by guaranteeing coverage for people with pre-existing conditions and expanding eligibility for Medicaid, among other provisions.