LLQP Accident & Sickness · Component 3.1 · 25% of the exam
For group health and dental, the insurer's underwriting of a small employer typically results in:
- Pooled rates based on the insurer's book for similar groups, with standard plan designs
- BExperience rating on the employer's own claims from the first renewal onward
- CNo coverage, since insurers require a minimum of twenty-five employees for health and dental
- DAn ASO arrangement, since small employers cannot afford fully insured premiums
Correct answer: A) Pooled rates based on the insurer's book for similar groups, with standard plan designs
Small groups lack credible claims data and are pooled. Larger groups are blended or fully experience-rated.
Why the other options are wrong
- BExperience rating needs credible claims volume.
- CSmall groups are insured through pooling.
- DASO suits large groups.
Exam tip
Small group: pooled rates, standard designs. Large group: experience rating.
Common mistake
Expecting a small group's good claims year to lower its renewal.
What this tests
CISRO competency component 3.1 — Implement a recommendation adapted to the client's needs and situation — which is weighted at 25% of the Accident & Sickness module. Written against the published curriculum.
More from component 3
- An underwriter assigns a disability applicant to occupational class 2 rather than class 4. The practical effect is that:
- A disability applicant discloses a back condition that resolved four years ago with no recurrence. The likely underwriting outcome is:
- Financial underwriting for an individual disability application exists to:
- A critical illness applicant's mother and sister both had breast cancer before fifty. The underwriter is likely to:
- An applicant for long-term care coverage is seventy-two. The insurer is most likely to require:
- Group long-term disability coverage within the non-evidence maximum is issued without individual medical questions because:
Practice the whole Accident & Sickness module
Timed sets weighted like the exam, and review of every question you miss. Free to start.