When can a group health policy renewal be denied according to HIPAA?

• A. When premiums are increased
• B. When contribution or participation rules have been violated
• C. When the policy term ends
• D. When benefit limits are reached

Answer: (B)

Group health plans are designed to be renewed, but HIPAA allows denial of renewal only for specific, legitimate reasons tied to the group’s eligibility and funding obligations. If the employer fails to meet the plan’s contribution or participation rules—such as not making required contributions or not maintaining the required employee participation thresholds—the insurer may refuse to renew the policy. This keeps the plan compliant with its terms and prevents adverse selection.

Raising premiums by itself isn’t a basis to deny renewal—the renewal would typically continue with the new премиум terms in the next contract period. Simply the end of a policy term ends coverage but isn’t described as a renewal denial. Reaching benefit limits in one term doesn’t automatically trigger nonrenewal; a new term would proceed under the plan’s current terms.