In a group health plan, who typically receives a certificate of coverage?

• A. Employee
• B. Employer
• C. Insurance company
• D. Dependent

Answer: (A)

In a group health plan, the certificate of coverage is the document that proves an enrolled person has coverage under the plan. The master policy is issued to the employer, but the insurer provides a certificate of coverage to each enrolled individual so they have personal proof of benefits.

The employee is the typical recipient because they are the primary insured under the group plan, and this certificate serves as their evidence of coverage. Dependents can also receive certificates, but the most common and expected recipient is the employee. The employer doesn’t receive a certificate for coverage in the same way, since they’re not the insured; the insurer issues the policy, and the employee (and any dependents) receive the certificates.