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Mini-COBRA

Posted on May 17th, 2023

“Mini-COBRA” is a term commonly used for states that have passed a law to require continuation of coverage rights for group insurance plans that are regulated by the state. Most commonly, Mini-COBRA applies to fully insured medical plans and Health Maintenance Organizations (HMOs). A handful of states also extend continuation of coverage rights to fully insured dental and/or vision plans, and one state (Minnesota) extends continuation of coverage rights to group term life insurance. Mini-COBRA generally does not apply to self-funded plans, level funded plans, Flexible Spending Accounts (FSAs), or Health Reimbursement Arrangements (HRAs).
 

Mini-COBRA is similar to COBRA that is regulated by federal law in many circumstances, but it is not identical. Mini-COBRA rights generally become available when there is a loss of coverage due to a qualifying event (e.g., termination of employment or a reduction in hours). Each state that has a Mini-COBRA law in place will have its own rules, such as the qualifying events that trigger Mini-COBRA rights, the plans that are subject to Mini-COBRA, the maximum duration of coverage that must be offered under Mini-COBRA, and the maximum premium that can be charged for Mini-COBRA.
 

Mini-COBRA requirements will be unique in each state, but at a high level, most Mini-COBRA requirements fall into one of these “buckets”:
 

Some states have no Mini-COBRA law, and therefore there are no continuation of coverage rights under state law.
Some states have Mini-COBRA laws that only apply to employers that are not subject to COBRA under federal law (i.e., employers with fewer than 20 employees).
Some states have Mini-COBRA laws that apply to employers that are not subject to COBRA under federal law, and the Mini-COBRA law extends the maximum duration of coverage required under federal law for certain plans.
A select few states have complicated Mini-COBRA laws that differ greatly from COBRA requirements under federal law.
 

In some instances, Mini-COBRA can be complicated to administer. The reason being that several Mini-COBRA laws are not well defined in its requirements. For example, some Mini-COBRA laws do not address whether family members have independent election rights, whether secondary qualifying events are available to extend the maximum duration of Mini-COBRA, or whether a grace period is allowed for late premium payments. Employers may need to rely on the insurance carrier for further guidance on Mini-COBRA.

 

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