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State-specific laws for COBRA
When you leave a job, the federal COBRA law (Consolidated Omnibus Budget Reconciliation Act of 1985) guarantees you the right to continue to buy your employer's group health insurance for up to 18 months. COBRA applies to companies that employ 20 more people (including part-timers), and that have group health plans.
COBRA participants pay the full premium of the company's group health plan out of their own pockets, plus up to a 2 percent administrative fee. Most states have also passed laws that expand that right to those working in smaller companies, usually with two to 19 employees. The chart below shows which states have "mini-COBRA" laws. (Remember that self-insured health plans are not subject to state insurance laws; they are governed only by the U.S. Department of Labor.) It's important to know your COBRA rights.
Eligibility for "mini-COBRA" by state
Length of time eligible for COBRA
|District of Columbia||3 months|
|New Hampshire||36 months|
|New Jersey||36 months|
|New Mexico||6 months|
|New York||36 months*|
|North Carolina*||18 months|
|North Dakota||36 months|
|Rhode Island||18 months|
|South Carolina||6 months|
|South Dakota||36 months|
|West Virginia||18 months|
|*In these states, group carriers have the discretion not to continue coverage for certain coverage benefits such as prescription drug coverage, dental benefits and vision benefits.|
|Source: The Kaiser Family Foundation at statehealthfacts.org and Georgetown University's "Consumer Guides For Getting and Keeping Health Insurance."|
Other related state laws
1. In Virginia, insurers have the option of offering either continuation or conversion.
2. In Washington, insurers are required to offer employees the option of having a continuation coverage provision; however, continuation coverage is not mandated in group policies.
3.In Idaho, except extension of benefits up to 12 months for individuals that are pregnant or disabled, generally there is no continuation coverage.
4. Six states have continuation laws that extend, for certain individuals (generally 55 and older), continuation coverage to the time when the individual is eligible for Medicare. These states are Illinois, Louisiana, Maryland, Missouri, New Hampshire and Oregon.
5. States without continuation coverage for small firms: Alabama, Alaska, Arizona, Delaware, Idaho, Indiana, Michigan, Montana, Pennsylvania, Virginia and Washington.
6. The New Mexico Health Insurance Alliance permits some individuals to continue to maintain Alliance coverage indefinitely. In order to be eligible, an individual must have maintained Alliance group coverage for six months and no longer be eligible for this coverage for almost all reasons (i.e., loss of employment, loss of policy, death and divorce).
7. In North Dakota, except in the case of divorce, continuation coverage lasts 39 weeks. In the case of divorce, continuation coverage can last up to 36 months.
8. In Oklahoma, the information applies to non-HMO plans. Longer periods of extension (3 to 6 months) are available for those undergoing treatment or are pregnant at termination of coverage. HMOs are required to extend coverage through pregnancy or ongoing inpatient treatment.
9. In Oregon, in the case of separation, divorce, or death of the insured, insurers are permitted to charge 102 percent of the group rate.
10. In South Dakota, the premium to continue coverage after 18 months increases to 150 percent.
Source: Kaiser Family Foundation