State By State Health Insurance Continuation Laws
Many states have adopted their own continuation of coverage laws, commonly called Mini-COBRA, to supplement federal COBRA requirements. These laws often apply to smaller employers that are not subject to federal rules and may include provisions such as longer coverage periods, additional notice requirements, or premium protections.
How Mini-COBRA Works By State
Mini-COBRA laws vary by state. Some states allow longer coverage periods than the standard 18 months provided under federal law, while others include additional notice requirements or premium protections. The list below identifies which states have enacted their own continuation of coverage laws in addition to federal COBRA requirements.
The chart provides an overview of COBRA continuation coverage options by state. It includes the average monthly COBRA premium, indicates whether the state follows Federal COBRA or Mini-COBRA regulations, and lists alternative coverage options such as short-term plans, accident-only plans, and Affordable Care Act Marketplace insurance.
Coverage & Definitions
- COBRA Continuation: Available in all 50 states for employers with 20 or more workers. This is your previous employer health plan. The cost is the entire premium, including the portion the employer subsidized.
- Mini-COBRA: Your state has a law that requires all employers to allow you to continue on your health plan after it would have normally ended. Many states allow you to continue your work health plan if the employer has 19 or fewer workers.
- Short Term: A type of medical insurance to be used as a temporary safety net for unexpected illnesses and accident injuries.
- Accident Only: A type of medical insurance that covers accidents only. No medical questions. Guaranteed Acceptance.
- Affordable Care Act: Major medical health insurance is similar to an employer’s group health plan with doctor, hospital, surgery, and prescription benefits. You may qualify for a subsidy to offset the cost.
State by State Continuation Rules
Frequently Asked Questions
Yes. Many states have Mini-COBRA laws that require small businesses with fewer than 20 employees to offer continuation of group health coverage. The specific rules and time limits depend on the state.
The length of continuation coverage under state COBRA laws varies. Some states provide only a few months of coverage, while others may offer up to 36 months. Employees should review their state’s requirements for exact timeframes.
State insurance departments generally oversee Mini-COBRA requirements. Employees and employers should contact their state insurance regulator for enforcement details and consumer assistance.
No. Federal COBRA applies to employers with 20 or more employees, while state COBRA laws apply to smaller businesses. State coverage may differ in cost, duration, and eligibility. Employees should compare both options if they qualify for each.
As this is a continuation of an employer health plan you recently were on, you will enroll back into your plan through the employer who it was with or their third-party administrator.
Will You Qualify For Health Insurance Continuation?
Answer a few questions in the COBRA Eligibility Survey to find out if you qualify for an extension of your employer health insurance. If the employer providing the group health plan has 19 or fewer workers, in some states you’ll qualify for Mini-COBRA.