In addition to the right of the employee to have a converted policy issued, the employee has the right to continue coverage under the group policy for a period of 12 months.
State Extension Requirements and Applicable Code Sections
The employer is responsible for providing the terminated insured written notification of the right to continue group coverage and the payment amounts required to continue coverage. This notice should be provided to the terminated insured within 30 days after the date group coverage terminates, and should specify the manner, place, and time in which the payment shall be made.
The payment amount for continued group coverage may not exceed 102% of the group rate.
Rules and procedures
Continuation of coverage is elected and premiums must be given to the employer within 30 days after receiving notice.
The terminated insured continues coverage without interruption unless:
- The terminated insured ceases to reside in this state.
- The terminated insured fails to make timely payment.
- The terminated insured violates a material condition of the contract.
- The terminated insured becomes eligible for similar coverage under another group policy.
- The employer’s coverage is terminated.
If the employer replaces coverage with coverage under another group policy, the terminated insured has the right to obtain coverage under the replacement group plan.
At the end of the extension of benefit period the covered person is eligible for a conversion policy.
HIPAA Federal Register citations
- Health Insurance Portability for Group Health Plans; Interim Rules and Proposed Rule. Federal Register / Vol. 62, No. 67/ Tuesday, April 8, 1997 / Rules and Regulation.
- Section 144.103, COBRA definition, (4) Continuation Coverage.