The Consolidated Omnibus Budget Reconciliation
Act of 1985 (COBRA) generally provides that certain qualified beneficiaries who
lose coverage under an employer-sponsored health plan may elect to continue
coverage under the plan in certain situations. COBRA applies only to employers
with 20 or more employees. If an employer has fewer than 20 employees, those
employees may have continuation coverage rights under state continuation
coverage law (sometimes referred to as “mini-COBRA”) rather than COBRA. This article
provides an overview of Ohio law on health plan continuation coverage under
Ohio’s mini-COBRA provisions.
Q: My employer has fewer than 20 employees and my
employment has just been terminated. Am I eligible for health coverage under
the Ohio continuation law?
A: To be eligible under
the Ohio continuation law, you must have been:
insured under a group policy during the
three-month period before your employment was
terminated for reasons other than gross misconduct; and
covered or eligible for coverage under Medicare, or under other group coverage.
You should check the terms of your
former employer’s group insurance coverage to determine what continuation
benefits you may be entitled to receive.
Q: How long
might my coverage last under the state continuation law?
coverage may continue for up to 12 months.
Q: What benefits may be continued under the state
A: The continuation coverage
requirement covers hospital, surgical and major medical benefits. In addition,
continuation coverage must include prescription drugs if this coverage is
included in the group coverage. Continuation need not cover dental or vision
Q: How do I go about electing continuation coverage?
must apply within the earlier of:
31 days of losing coverage;
10 days from the day your
coverage would otherwise end if you received notice of continuation rights
before you lost your coverage; or
10 days from the date you
received notice about continuation coverage, if you received such notice after you
lost your coverage.
Q: Must employers in Ohio with fewer than 20 employees
notify employees of the right to continue coverage at the time they are
A: Yes. Ohio law requires small
employers to notify an employee of the right to state continuation coverage
when the employee is notified of the employment termination. This notice must
include details of the required monthly payment amount for continuation
coverage (including the manner of payment).
Q: What if my former employer does not agree that I am
eligible for group continuation coverage?
A: You may contact the
Ohio Department of Insurance (ODI) at (800) 686-1526 if you believe the
insurance company is not complying with state group continuation coverage
rules, or to get more information about state continuation law. Information is
also available through www.insurance.ohio.gov
(type “COBRA” in the search box).
This “Law You Can Use” column was provided by the
Ohio State Bar Association. It was prepared by Jason
Rothman and Charles Billington, attorneys in the Cleveland office of the
international labor and employment law firm of Ogletree, Deakins, Nash, Smoak
& Stewart, P.C. Articles appearing in this column are intended to provide broad,
general information about the law. Before applying this information to a
specific legal problem, readers are urged to seek advice from an attorney.
Labels: COBRA, health care, Ohio continuation law