The coverage, conditions, and limitations in the master policy of a group contract can be found in which document?

• A. The certificate of coverage and benefits
• B. The master policy
• C. Rider
• D. Endorsement

Answer: (A)

In a group life policy, the master policy is the contract between the insurer and the employer, laying out who is covered and the general terms of the plan. The document that conveys the actual protection available to each employee under that plan is the certificate of coverage (certificate of benefits). This certificate translates the master policy into the employee’s specific terms, detailing the benefits, coverage amounts, eligibility, and any limitations or exclusions that apply to the individual. Riders and endorsements modify the master policy, but they don’t provide the employee’s coverage details. So, the certificate of coverage is where the coverage, conditions, and limitations for the insured member are found.