State Continuation Coverage

COBRA for smaller employers

Federal COBRA only applies to employers with 20 or more employees. Many states fill that gap with their own continuation laws, often called mini-COBRA. These laws let employees of smaller businesses keep their group health plan for a period after leaving a job or losing eligibility.

Florida, for example, has a continuation law for insured group plans at employers with fewer than 20 employees. Other states have their own rules, and some also extend coverage beyond federal COBRA limits.

How state continuation usually works

Details vary by state, but common features include:

• Coverage for a set period, often up to 18 months.
• The same plan and network you had while employed.
• You pay the full premium, and some states allow a surcharge above the group rate.
• Strict deadlines to notify the insurer and elect coverage.
• Coverage that applies only to fully insured plans, not self-funded ones.

In many states, you deal directly with the insurance company rather than with your former employer.

Example

Gabriel works for a six-person dental office in Tampa. He leaves in August to start a mobile detailing business. Because the practice has fewer than 20 employees, federal COBRA does not apply, but Florida's continuation law does.

• He receives information about his continuation rights and must respond within the state deadline.
• He compares the continuation premium with individual options.
• His wife is pregnant and their obstetrician is in the group plan network, so he elects continuation through the end of the year to keep her care uninterrupted.
• During open enrollment, he shops for a 2027 family plan and switches January 1.

Deadlines matter

State continuation deadlines are often shorter or less forgiving than federal COBRA. Missing a notice deadline can mean losing the right to continue. If you work for a small business and are leaving, ask the employer or insurer about continuation rights before your last day.

Comparing your options

Losing job coverage also opens a 60-day special enrollment period for Marketplace plans. Healthy people can also apply for private underwritten plans year-round. Weigh:

• The full continuation premium versus individual options.
• Whether you are mid-treatment or close to meeting your deductible.
• Whether your doctors are in individual plan networks.
• Whether your projected income qualifies for a premium tax credit.

Marketplace vs private plans

State continuation keeps your group plan. A Marketplace plan may cost less if you qualify for a subsidy; a private plan may cost less if you are healthy and above the subsidy line. Do not let the special enrollment window close while you decide.

Our COBRA alternatives guide and health insurance between jobs walk through the decision. To compare continuation with individual plans, request a quote.