COBRA Law Summaries
Kentucky, COBRA Law Summaries
Kentucky's health care continuation law is codified in the Kentucky Revised Statutes at Title XXV, Ch. 304.
DEFINITIONS
“Group policy” means group health insurance policies and blanket health insurance policies which (Sec. 304.18-110, as amended by Ch. 120 (H. 352), L. 2001):
affect the rights of a Kentucky insured and bear a reasonable relation to Kentucky, regardless of whether delivered or issued for delivery in Kentucky;
provide hospital or surgical expenses benefits, other than for a specific disease or accidental injury only; and
are delivered, issued for delivery or renewed after July 15, 1986.
“Medicare” means Title XVIII of the U.S. Social Security Act as amended or superseded (Sec. 304.18-110, as amended by Ch. 120 (H. 352), L. 2001).
COVERAGE
Kentucky's health care continuation law requires employers maintaining group health insurance polices that affect the rights of a Kentucky insured and bear a reasonable relation to Kentucky (regardless of whether the policies are issued for delivery in Kentucky) to offer continuation coverage (Sec. 304.18-110, as amended by Ch. 120 (H. 352), L. 2001).
PROCEDURES
An employer must offer continuation coverage to persons insured under group policies and their dependents, so long as the group member has been covered by the group policy for at least three months. Surviving or divorced spouses of group members are also eligible. Continuation coverage is not available if the insured person is eligible for Medicare or for other group coverage (Sec. 304.18-110, as amended by Ch. 120 (H. 352), L. 2001).
The insurer must give written notice of the right to continue coverage upon notice from the group policyholder that the group member has terminated group coverage. The insured person's election period does not begin to run until this notice has been delivered to the insured person's last known address (Sec. 304.18-110, as amended by Ch. 120 (H. 352), L. 2001).
Insured persons must elect continuation coverage by giving notice to the insurer and payment of the required premium within 31 days after receiving notice of their continuation rights (Sec. 304.18-110, as amended by Ch. 120 (H. 352), L. 2001).
WHAT THE EMPLOYER MUST DO
An employer must offer continuation coverage to persons insured under group policies and their dependents, so long as the group member has been covered by the group policy for at least three months. Surviving or divorced spouses or group members are also eligible (Sec. 304.18-110, as amended by Ch. 120 (H. 352), L. 2001).
Eligibility requirements.- Persons insured under group policies have the right upon termination of group coverage to continue coverage for themselves and their dependents, so long as the group member has been covered by the group policy for at least three months. Surviving or divorced spouses of group members are also eligible. Continuation coverage is not available if the insured person is eligible for Medicare or for other group coverage (Sec. 304.18-110, as amended by Ch. 120 (H. 352), L. 2001).
Conversion to individual policy.- Persons insured under group policies have the right upon termination of group coverage to have a conversion policy issued, so long as the group member has been covered by the group policy for at least three months. Surviving or divorced spouses of group members are also eligible. Conversion coverage is not available if the group member is eligible for Medicare or for other group coverage that, together with the converted coverage, would result in overinsurance (Sec. 304.18-110, as amended by Ch. 120 (H. 352), L. 2001).
Notice.- The insurer must give written notice of the right to convert coverage upon termination of continued coverage. The group member's election period does not begin to run until this notice has been delivered to the insured person's last known address (Sec. 304.18-110, as amended by Ch. 120 (H. 352), L. 2001).
Deadlines.- Group members must elect conversion coverage by giving notice to the insurer within 31 days after receiving notice of their conversion rights (Sec. 304.18-110, as amended by Ch. 120 (H. 352), L. 2001).
Premiums.- The premium must be set according to the insurer's table of premium rates in effect on the later of the effective date of the converted policy or the date of the application when the premium rate applies to the class of risk to which the covered persons belong, to their ages, and to the form and amount of insurance provided (Sec. 304.18-110, as amended by Ch. 120 (H. 352), L. 2001).
Termination of coverage.- The conversion policy may provide that coverage may be terminated if the group member is eligible for Medicare (Sec. 304.18-120).
Duration of coverage.- Continuation coverage generally lasts for 18 months (Sec. 304.18-110, as amended by Ch. 120 (H. 352), L. 2001).
Premiums.- For conversion coverage, the premium must be set according to the insurer's table of premium rates in effect on the later of the effective date of the converted policy or the date of the application when the premium rate applies to the class of risk to which the covered persons belong, to their ages, and to the form and amount of insurance provided (Sec. 304.18-110, as amended by Ch. 120 (H. 352), L. 2001).
Termination of coverage: Continuation coverage.- Continuation coverage will terminate if the group member fails to make a timely premium payment, or if the group policy is terminated and not replaced by another group policy within 31 days (Sec. 304.18-110, as amended by Ch. 120 (H. 352), L. 2001).
Termination of coverage: Conversion coverage.- The conversion policy may provide that coverage may be terminated if the group member is eligible for Medicare (Sec. 304.18-120).
NOTICE
Continuation coverage.- The insurer must give written notice of the right to continue coverage upon notice from the group policyholder that the group member has terminated group coverage. The insured person's election period does not begin to run until this notice has been delivered to the insured person's last known address (Sec. 304.18-110, as amended by Ch. 120 (H. 352), L. 2001).
Conversion coverage.- The insurer must give written notice of the right to convert coverage upon termination of continued coverage. The group member's election period does not begin to run until this notice has been delivered to the insured person's last known address (Sec. 304.18-110, as amended by Ch. 120 (H. 352), L. 2001).
DEADLINES
Continuation coverage.- Insured persons must elect continuation coverage by giving notice to the insurer and payment of the required premium within 31 days after receiving notice of their continuation rights (Sec. 304.18-110, as amended by Ch. 120 (H. 352), L. 2001).
Conversion coverage.- Group members must elect conversion coverage by giving notice to the insurer within 31 days after receiving notice of their conversion rights (Sec. 304.18-110, as amended by Ch. 120 (H. 352), L. 2001).
<p>Conversion coverage.— Group members must elect conversion coverage by giving notice to the insurer within 31 days after receiving notice of their conversion rig</p>