Ohio provides continuing “Mini-COBRA” coverage for small business employees

By Jason Rothman

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 to employees 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 fact sheet provides an overview of Ohio law on health plan continuation coverage under Ohio’s mini-COBRA provisions.

Q: Who is eligible for coverage under the Ohio continuation law?
A: In order to be eligible under the Ohio continuation law, an employee must have been:
1. Continuously insured under a group policy during the three-month period preceding the termination of employment;
2. Involuntarily terminated for reasons other than gross misconduct; and
3. Not covered or eligible for coverage under Medicare, or under other group coverage.                    

An employee should check the terms of the employer’s group insurance coverage to determine what continuation benefits the employee is entitled to receive.

Q: How long may coverage last under the state continuation law?
A: Individuals may continue coverage for a period of up to 12 months (up from six months under prior law).

Q: What benefits may be continued under the state continuation law?
A: This 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 care.

Q: How does an individual elect continuation coverage?
A: The employee must apply within the earlier of:
1. 31 days of losing coverage;
2. 10 days from the day the employee’s coverage would otherwise terminate if the employee received notice of continuation rights before loss of coverage; or
3. 10 days from the date the employee received notice about continuation coverage, if the employee received such notice after losing coverage.

Q: Must employers in Ohio with fewer than 20 employees notify employees of the right to continue coverage at the time they are involuntarily terminated?
A: 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 there is a disagreement about whether a former employee is eligible for group continuation coverage?
A: Former employees may contact the Ohio Department of Insurance (ODI) at (800) 686-1526 if they believe the insurance company is not complying with state group continuation coverage rules, or for more information about state continuation law. Information is also available through www.insurance.ohio.gov (type “COBRA” in the search box).

Jason Rothman is an attorney in the Cleveland office of the international labor and employment law firm  of Ogletree, Deakins, Nash, Smoak & Stewart, P.C.



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