If the employer ceases operations and terminates the policy or contract, every group health insurance policy must have coverage continued for the employees and their eligible dependents for 12 months for which the employee or dependent is financially responsible.
South Dakota Employer Responsibility
If an employer fails to submit premium payment to the insurance company resulting in loss of coverage to your employees or cancels the coverage and you do not notify the employees of such loss of coverage, the employees and their dependents are then eligible for continuation provided election is made within sixty days of the date of their being notified of the loss of coverage.
Compare South Dakota COBRA Health Alternatives in the green box near the top.
The employer shall provide notice of any nonpayment of premiums or cancellation of coverage to employees as soon as reasonably possible but no later than ten days after the date of cancellation. If you as an employer fail to notify the employees and their dependents of the termination of coverage within ten days, the employees and dependents may not be denied coverage by the insurer provided timely election is made after actual receipt of notice. Whether notice is provided or not, the election period for continuation of coverage may expire ninety days from the date the group coverage terminated.
Any former employee who is under continuation coverage at the time an employer ceases operation and terminates the policy, or fails to make premium payments resulting in loss of coverage, or cancels the insurance without notice, is eligible to remain on continuation coverage for the remainder of the continuation term or twelve months, whichever is less, if timely election is made and continuation payments received.
For purposes of this section, the phrase, employer ceasing operations, means that the business has closed or discontinued its business operations or, in the case of a sole proprietorship or an owner- operated business, the sale of such business that results in the purchaser establishing its own taxpayer identification number
Continuation is only available to an employee who has been continuously insured under the group policy or under any creditable coverage which it replaced during the entire six-month period ending with such termination
South Dakota 58-18-7.5
Continuation of coverage upon leaving employment or termination of coverage by insurer--Duration.
Every health benefit program that is self-insured, and every policy of group health insurance providing benefits for hospital or medical expenses delivered or issued for delivery in this state, by a commercial health insurance company, by a nonprofit medical and surgical service plan corporation, by a nonprofit hospital service plan corporation, by a health maintenance organization or by any other similar mechanism shall, in addition to the provisions required by law, include that employees have a right upon leaving employment or the termination of the coverage by the insurer, other than the termination of the policy or contract itself and the replacement thereof by similar coverage, to have the coverage continue for themselves and their eligible dependents for a period of eighteen months for which the employee shall be financially responsible. In the case of a qualified beneficiary who is determined under title II or XVI of the Social Security Act (42 U.S.C. 401) to have been disabled at any time during the first sixty days of continuation coverage, coverage can be continued for twenty-nine months. Nonpayment of the premium by the employer is termination by the employer.
Under COBRA, a terminated employee is entitled to continue his or her group health insurance for 18-36 months. The employee is entitled to the same coverage as current employees, since it is a seamless continuation of the current plan.
Cobra Insurance Notice
Most problems and confusion regarding COBRA Insurance involve misinformed employers who aren't aware they're supposed to offer employees COBRA. Read our Sample COBRA Notice. Also some employees thinking they should get their COBRA upon termination. Read about COBRA notification time requirements.
COBRA Insurance Cost
The 65% COBRA subsidy was for employees losing their health insurance from
Sept. 1, 2008 to after May 31st, 2010. That was part of the stimulus bill. Now the employee will be required to pay the full cost of health insurance, including any portion formerly paid by the employer. In addition, the employer can charge a 2% COBRA administration fee, bringing the total payment to 102% of the premium.
Who Qualifies for COBRA?
Employers with over 20 full time employers usually have to offer COBRA to an employee within 45-60 days of the qualifying event. Qualifying events include the employee losing their health insurance for a variety of reasons including a reduction in hours or termination. Dependents who lose insurance for other reasons, such as divorce, also qualify for COBRA. Exceptions include employees terminated for willful gross misconduct, employers with less than 20 total employees, non profits or churches organizations.
No Mini Cobra Coverage
47 of the 50 U.S. states have COBRA laws that cover smaller employers, generally called state mini-cobra laws. States that have not passed a mini-cobra law include Alabama, Alaska, and Delaware.
Among States that have mini-cobra laws, the lengths of coverage vary from 30 days to 36 months. Please refer to our Mini State COBRA Law Directory.
Written by Craig J. Casey
Craig Casey is an Writer, Coach, Blogger, Husband, and Former Health Insurance Agent helping people on the web since 1999 with their health insurance problems.
blog comments powered by Disqus
About COBRA
Employers who offer group health care plans to a minimum of 20 employees must comply with ERISA (the Employee Retirement Income Security Act of 1974). The Federal version or the Consolidated Omnibus Budget Reconciliation Act of 1986 (COBRA), requires that most group health plans provide 18-36 months of continuing health insurance.
