Which parties are directly involved in a group accident and health insurance contract?

• A. Insurer and employees
• B. Insurer and employer
• C. Insurer, employees, and employer
• D. Employer and employees

Answer: (B)

In a group accident and health plan, the contract is formed between the insurer and the employer. The employer is the policyholder and enters into the master policy with the insurer, often paying the premium (alone or with employee contributions). Employees are covered under that master policy through certificates of coverage, but they are not direct contracting parties to the master contract. That’s why the key relationship is between the insurer and the employer. The other option would imply employees are direct parties to the contract, which isn’t the usual structure for group plans.