State COBRA expansion programs extend coverage to employees of firms with fewer than 20 workers otherwise not covered by COBRA, the federal law. Eligiblilty rules for state continuation rights may differed from those under the federal law. In addition, protections such as duration and rate restrictions may also differ.

Data as of January 2010. Data compiled through review of federal and state laws. For more detailed information on consumer protections in any state see Georgetown University's "Consumer Guides For Getting and Keeping Health Insurance" available at http://www.healthinsuranceinfo.net/.
Data collection and analysis by researchers at the Health Policy Institute, Georgetown University.

COBRA: Consolidated Omnibus Budget Reconciliation Act of 1985. COBRA amended the Employee Retirement Income Security Act of 1974 to require temporary group continuation health insurance for employees and their dependents. The federal law applies only to employees in firms with 20 or more workers.

Maximum Duration of Continuation Coverage: Actual duration of state continuation coverage may be less depending on the qualifying event.
Rating Restrictions: Percentage of the Group Rate: Under all state continuation coverage laws, the person electing continuation coverage must pay the entire premium (employee and employer) share and, in some states, an administrative fee. The added administrative fee varies from state to state but is typically 2% of the total premium. Similar to the federal COBRA provisions, many states permit insurers to charge much higher premiums (typically 150% of the group rate) for those electing state continuation coverage because disability. These states are not reflected on the charts.

1. Six states have continuation laws that extend, for certain individuals (generally 55 and older), following certain qualifying events, continuation coverage to the time when the individual is eligible for Medicare. These states include Illinois, Louisiana, Maryland, Missouri, New Hampshire, and Oregon. In addition, in New Mexico, group plans offered through the New Mexico Health Insurance Alliance continue coverage indefinitely.
2. In New Jersey, an individual considered "disabled," under some circumstances, may continue coverage until they are no longer considered disabled.
3. The New Mexico Health Insurance Alliance permits some individuals to continue to maintain Alliance coverage indefinitely. In order to be eligible an individual must have maintained Alliance group coverage for 6 months and no longer be eligible for this coverage for almost all reasons (i.e. loss of employment, loss of policy, aging off parents' policy, death, divorce). Premiums for continuation coverage through the Alliance are about 9 percent higher than typical group premiums.
4. In North Dakota, except in the case of divorce, continuation coverage lasts 39 weeks. In the case of divorce, continuation coverage can last up to 36 months, and insurers are permitted to charge 102% of the group rate.
5. Information applies to non-HMO plans. There are longer periods of extension (3-6 months) for those undergoing treatment or pregnancy at termination of coverage. HMO's are required to extend coverage through pregnancy or ongoing inpatient treatment.
6. In Oregon, in the case of separation, divorce, or death of the insured, insurers are permitted to charge 102% of the group rate.
7. In South Dakota, the premium to continue coverage after 18 months increases to 150%.
8. In Virginia, insurers have the option of offering either continuation or conversion.
9. In Washington, insurers are required to offer employers the option of having a continuation coverage provision, however, continuation coverage is not mandated in group policies.