Healthy Access Database

Continuation of Coverage Options

This section provides information about health coverage continuation options for people who lose their group health insurance coverage, due to a job change, a divorce, job loss or other reason. This includes information about COBRA benefits, state continuation of coverage options for people who are not covered by COBRA, and federally mandated group-to-individual health insurance portability benefits.

COBRA
Many organizations that employ more than 20 people and offer health benefits are required to allow employees and their dependents to temporarily continue their health insurance coverage for specified time periods and under specified conditions even after they would no longer be traditionally eligible for that coverage. The federal legislation that requires this is known as the Consolidate Omnibus Budget Reconciliation Act of 1985 (COBRA). This section explains people's rights under COBRA, which do not vary by state.

State Continuation and/or Individual Conversion Plans
Many states have enacted legislation requiring smaller employers or those not bound by the COBRA provisions to offer some type of continuation of coverage benefit to their employees. In addition, many states have requirements that allow individuals who are transitioning out of group coverage to convert their group health coverage into an individual health insurance plan that they pay for privately. This section explains these state-specific provisions.

HIPAA Group-to Individual Portability Coverage
The federal Health Insurance Portability and Accountability Act of 1996 (HIPAA) mandated that every state develop at least one option for individuals who are transitioning out of a group health insurance plan and meet certain criteria, so that they can purchase an individual health insurance policy without regard to their health status. The people who are eligible to purchase these health insurance policies are known as having group-to-individual portability rights under HIPAA and are often called HIPAA-eligibles. The various states have developed a wide range of mechanisms to provide guarantee-issue coverage to their HIPAA-eligible populations, and they are all outlined in this section.

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