An eligible employee can be excluded from group health coverage for up to __ months if he/she is considered a 'late enrollee'?

• A. 6
• B. 12
• C. 18
• D. 24

Answer: (C)

When a group health plan uses a preexisting condition exclusion, it can delay coverage for conditions that existed before enrollment. If someone enrolls right when they first become eligible, the exclusion period can run for up to 12 months. If the person is a late enrollee—enrolling after the initial window—the plan may apply the exclusion for as long as 18 months from the start of coverage. This recognizes the delay in enrolling but caps how long a preexisting condition can be excluded. Note that prior, continuous creditable coverage can reduce this exclusion period, potentially shortening or eliminating it. So for a late enrollee, the maximum exclusion is 18 months.