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Health · Chapter 22 · Group Health

Association and Labor Union Groups (FL)

Definition
A policy may be issued to an association (including a labor union) only if it: has a constitution and bylaws; has at least twenty-five (25) individual members; has been organized and maintained for at least one (1) year for purposes OTHER than obtaining insurance; is itself the policyholder; and at least fifteen (15) individual members enroll. All members must be declared eligible and acceptable at issuance; spouses and dependent children may be insured with or without the member. A single master policy may bundle multiple health plans from the same insurer or affiliated group as alternatives.
In plain English
Real club first, insurance second: 25 members, a year of existence, bylaws — and at least 15 who actually sign up.
Exam tip
Number chain to memorize: 25 members · 1 year · 15 enrolled.
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