According to HIPAA, renewal of a group health policy can be denied if

• A. The employee forgets to enroll
• B. Contribution or participation rules have been violated
• C. The policy term is shorter than 12 months
• D. The employer fails to file a claim

Answer: (B)

HIPAA allows a group health policy to continue renewals as long as the employer and plan meet certain conditions. The key reason a renewal can be denied is if the employer violates the plan’s contribution or participation rules. These rules set who must be covered and how much the employer must contribute. If those requirements aren’t met, the insurer can refuse to renew the policy at the end of the term.

Forgetting to enroll doesn’t trigger a renewal denial because renewal is about ongoing coverage and eligibility, not an individual’s enrollment timing. The policy term being shorter than 12 months isn’t a stated HIPAA barrier to renewal, and whether the employer files a claim isn’t a factor in renewing the policy.