Alyssa Lane
The Consolidated Omnibus Budget Reconciliation Act (COBRA) gives workers and their families the right to continue purchasing group health insurance for limited periods when they would otherwise lose coverage due to certain events. This includes voluntary or involuntary job loss, reduction in hours, transition between jobs, death, divorce, and other life events. In New York, eligible individuals can continue their employer-sponsored group health insurance through a combination of federal COBRA and the state's Mini-COBRA program. This allows individuals to maintain coverage for up to 36 months. While dependent children typically lose coverage when they turn 26, the make-available requirement in New York allows insurers to extend coverage to qualifying young adults up to age 29 as dependents under family coverage.
| Characteristics | Values |
|---|---|
| Qualifying events | Voluntary or involuntary job loss, reduction in hours, transition between jobs, death, divorce, and other life events |
| Qualifying beneficiaries | Covered employee, spouse of the covered employee, dependent child of the covered employee |
| Exclusions | Medicare-eligible individuals and certain non-resident aliens |
| Coverage duration | Up to 36 months from the date of the qualifying event |
| Premium payment | Individuals pay up to 102% of the premium cost |
| Application process | Submit a written election to the employer or insurer within 60 days of receiving notification of rights |
| Initial premium payment | Due within 45 days of election |
| Subsequent premium payments | Monthly, with a 30-day grace period |
| Additional state coverage | New York's Mini-COBRA law extends coverage to employers with fewer than 20 employees |
| Total coverage period | Federal COBRA (up to 18 months) + New York Mini-COBRA (up to 18 months) = Up to 36 months total |
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What You'll Learn
Qualifying events for COBRA insurance
The Consolidated Omnibus Budget Reconciliation Act (COBRA) outlines that qualifying events include voluntary or involuntary job loss, reduction in hours, transition between jobs, death, divorce, and other life events. In the case of job loss, COBRA coverage is available for up to 18 months, protecting workers and their qualified dependents. This includes retirement, which is considered "quitting your job". Additionally, employers must provide an option to continue the same insurance if employees are scheduled for fewer hours than required for employer-sponsored insurance.
When a qualifying event is related to family separation, such as death, divorce, or separation, former spouses and dependents are given the right to extend their insurance benefits for up to 36 months. Relationship status changes between the insurance policyholder, their spouse, and other qualified beneficiaries on the health plan are also considered qualifying events. For instance, if a covered employee passes away, their spouse and qualified dependents can continue the same group workplace insurance coverage for 36 months.
Other qualifying events include becoming entitled to Medicare or becoming covered by another insured or uninsured group arrangement that provides hospital or surgical benefits. It's important to note that Medicare eligibility does not qualify for COBRA coverage. The length of COBRA coverage depends on the type of qualifying event, with coverage ranging from 18 to 36 months.
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Employer requirements
The Consolidated Omnibus Budget Reconciliation Act (COBRA) gives workers and their families the right to continue purchasing group health insurance for limited periods of time when they would otherwise lose coverage due to certain events. This federal law applies to employers with 20 or more employees.
In the case of employers with fewer than 20 employees, New York State law requires them to provide the equivalent of COBRA benefits. This means that workers are entitled to 36 months of continued health coverage, at a monthly cost of up to 102% of the actual cost to the employer.
In general, employers with 20 or more employees who provide group health plans must offer each "qualified beneficiary" who would otherwise lose coverage under the plan because of a "qualifying event" an opportunity to elect to continue the coverage they had before the qualifying event. A qualified beneficiary can be the covered employee, the spouse of the covered employee, or the dependent child of the covered employee.
Qualifying events include voluntary or involuntary job loss, reduction in hours, transition between jobs, death, divorce, and other life events. Employers have a responsibility to notify their plan administrator of a qualifying event within 30 days.
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Coverage duration
The length of time a person may have federal COBRA coverage depends on why they are losing coverage and can range from 18 to 36 months. In most circumstances, you can stay on COBRA for 18 months, with coverage potentially extending to 36 months.
COBRA insurance typically lasts 18 months for employees, with the coverage period providing flexibility to find other health insurance options. However, this can be extended to 29 months for those with a qualifying disability. If someone on the plan qualifies as disabled within the first 60 days of COBRA coverage, the coverage period may be extended to 29 months. To receive the extension, the disabled individual must be determined disabled by the Social Security Administration (SSA). The plan administrator must be notified within 60 days of receiving the SSA disability determination to qualify for the extension. The premium cost may increase by 150% of the standard premium during the additional 11 months.
Dependents on the plan, such as a spouse or children, can be eligible for up to 36 months of coverage under certain circumstances, like divorce or the death of the covered employee. Adult children lose their dependent status at age 26 and may use COBRA rights for 36 months to keep their parent's health insurance plan.
Under New York State's continuation coverage law, workers and their families who work for employers with fewer than 20 employees have the right to continue to purchase group health insurance for limited periods of time when they would otherwise lose coverage due to certain events.
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Cost of coverage
The cost of COBRA coverage in New York State can vary depending on several factors, including the number of employees at the company, the length of coverage, and the type of plan. Here is a detailed breakdown of the cost of coverage:
Firstly, it's important to understand that COBRA is a continuation of your previous employer-provided health insurance plan. This means that you will be responsible for paying the full premium amount, which includes both the portion previously paid by your employer and your own contributions. This shift in responsibility leads to COBRA insurance often appearing more expensive, even though the actual cost of coverage remains unchanged.
Qualified individuals may be required to pay up to 102% of the premium cost for COBRA coverage. This includes both the employee and employer contributions, and an administrative fee of up to 2% may be charged by the employer. The total monthly cost for continuing coverage under COBRA can be estimated by identifying the amount deducted from your paycheck for health insurance and adding it to the amount contributed by your employer.
The length of time an individual may have federal COBRA coverage depends on their specific situation, and it can range from 18 to 36 months. In New York State, individuals with employers that have fewer than 20 employees are eligible for continuation coverage under the state's law, which resembles federal COBRA.
Additionally, it's worth noting that the cost of COBRA coverage can change if the underlying health plan premiums are adjusted during the coverage period. The average cost of individual health insurance in the United States varies by state, with a monthly average premium of $537 in 2025.
Finally, while COBRA can provide continued coverage, it is recommended to compare the benefits offered by your previous employer with the options available through the NY State of Health (NYSOH) or other insurers in your area. Individuals and families may also explore free or low-cost coverage options through Medicaid or Child Health Plus.
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Eligibility for dependents
In New York, eligible individuals may continue their employer-sponsored group health insurance following qualifying events such as termination of employment, reduction in work hours, or other circumstances resulting in the loss of coverage. This continuation is provided through a combination of federal COBRA and the state's Mini-COBRA program. Under federal COBRA, individuals may be eligible for up to 18 months of continued coverage if their employer has 20 or more employees.
Federal COBRA law applies to any group health plan, whether the employer has purchased insurance coverage or is self-insured, where the employer had 20 or more employees in the previous year. It covers health plans in both the private and public sectors sponsored by state and local governments. It does not cover those sponsored by the federal government or certain church-related organizations.
New York's Mini-COBRA law includes all insured groups in the state, including those not covered under federal law: employers with 2 to 19 employees, certain government plans, and church plans. It also includes some individuals not covered by federal COBRA law, such as individuals fired for gross misconduct and domestic partners and same-sex spouses of employees.
Under federal COBRA, eligible individuals who voluntarily resign from a job, have their work hours reduced, or are terminated for any reason other than "gross misconduct" are guaranteed the right to continue their employer's group health coverage for up to 18 months. In some situations, the spouse and dependent children of the eligible employee are entitled to up to 36 months of COBRA coverage.
In New York, eligible individuals and their families are entitled to up to 36 months of coverage under the Mini-COBRA program. The entire premium cost must be paid by the individual or family member, and it is usually more expensive than health coverage for active employees because the individual pays the entire premium themselves.
To elect COBRA continuation of health coverage, the eligible person must complete a "COBRA - Continuation of Coverage Application." Employees and/or eligible family members can obtain application forms from their agency's payroll or personnel office.
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Frequently asked questions
The Consolidated Omnibus Budget Reconciliation Act (COBRA) gives workers and their families who lose their health benefits the right to continue their group health benefits for limited periods of time under certain circumstances.
Qualifying events include voluntary or involuntary job loss, reduction in hours, transition between jobs, death, divorce, and other life events.
Yes, dependent children are eligible for COBRA insurance in NYS. However, they lose coverage when they turn 26 years old. There is an option to extend coverage until the age of 29, but this is at the discretion of the employer or group.
The length of time a person may have COBRA coverage depends on why they are losing coverage, but it can range from 18 to 36 months.
Qualified individuals may be required to pay up to 102% of the premium cost. The premium will typically be between $400 and $700 per month, per insured person.
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