COBRA Law Summaries
Connecticut, COBRA Law Summaries
Connecticut's health care continuation law is codified in the General Statutes of Connecticut at Title 38a, Chapter 700c.
DEFINITIONS
“Employee” means any person engaged in service to an employer in a business of his or her employer (Sec. 381-531).
“Employer” means any person, firm, corporation, partnership or association engaged in business who has employees in Connecticut (Sec. 381-531).
COVERAGE
Connecticut's health care continuation law covers any employer providing group health insurance coverage for its employees (Sec. 38a-538, as amended by P.A. 97-268 (H. 6266), L. 1997, effective October 1, 1997).
PROCEDURES
An employer must offer continuation coverage to employees, their spouses and dependents, pursuant to the requirements of COBRA (Sec. 38a-538, as amended by P.A. 97-268 (H. 6266), L. 1997).
An employer providing group health insurance for employees is required to notify covered employees of their right to continuation coverage in accordance with requirements of COBRA (Sec. 38a-538, as amended by P.A. 97-268 (H. 6266), L. 1997, effective October 1, 1997).
An election to continue coverage must be made to the employer in accordance with the requirements of COBRA (Sec. 38a-538, as amended by P.A. 97-268 (H. 6266), L. 1997, effective October 1, 1997).
WHAT THE EMPLOYER MUST DO
Connecticut's health care continuation law requires an employer to offer continuation coverage to employees, their spouses and unmarried children under age 26, pursuant to the requirements of COBRA.
Disability of dependent child.- If a group health plan specifies that a dependent child's coverage must terminate upon that child's attainment of a specified age, the attainment of that age will not operate to terminate the coverage of the child while the child is unmarried and is incapable of self-sustaining employment by reason of mental or physical disability and chiefly dependent upon the employee for support and maintenance. Proof of disability and dependency must be furnished to the insurer by the employee within 31 days of the child's attainment of the specified age and thereafter, as may be required by the insurer, except that the insurer may not require proof more frequently than once every year (Sec. 38a-554(b), as amended by P.A. 08-147 (H. 5158), L. 2008, effective January 1, 2009).
Conversion to individual policy.- Connecticut residents are entitled to conversion coverage immediately upon termination of coverage under a group health insurance plan.
Qualifying events/Duration of coverage: Continuation coverage.- Loss of coverage due to: layoff; reduction of hours; leave of absence; and termination of employment, other than as a result of gross misconduct, triggers a right to continuation coverage for a period of 18 months. 36 months of continuation coverage must be provided after loss of coverage due to: death of the employee; the employee's divorce, court-ordered annulment, or legal separation; the employee's or dependent's eligibility for Medicaid; and a dependent ceasing to be a dependent. Continuation coverage may also be provided for any other qualifying event as set forth in COBRA in accordance with the terms specified in COBRA.
In addition, employees and covered dependents are entitled to 12 months of continuation coverage during an employee's continued absence due to illness or injury. Upon plan termination, individuals totally disabled on the date of termination who submit a disability claim within one year of plan termination must be provided 12 months of continued coverage without premium payment.
Temporary extension. -Individuals who did not have continuation of group health insurance coverage in effect on February 17, 2009, but who would be “assistance eligible” as defined in the American Recovery and Reinvestment Act of 2009 if continuation coverage had been in effect, may elect to continue such coverage if they elect not later than 60 days after they receive the notice described in this section. This continuation coverage starts with the first period of coverage beginning on or after February 17, 2009, and does not extend beyond the period that would have been allowed if the individual had otherwise elected continuation coverage. Each affected insurer and group policyholders that are employers with fewer than 20 employees must provide notice to such individuals not later than April 18, 2009, of the election period (H. 6715, L. 2009, Act 09-3, effective April 22, 2009).
Duration of coverage: Conversion coverage.- A conversion policy must offer terms and benefits that are at least equal to the terms and benefits of an individual comprehensive health care plan.
Premiums.- Premiums for continuation coverage may not exceed 102% of the actual cost of coverage (Sec. 38a-554, as amended by P.A. 08-147 (H. 5158), L. 2008, effective January 1, 2009).
NOTICE
An employer providing group health insurance for employees is required to notify covered employees of their right to continuation coverage in accordance with requirements of COBRA (Sec. 38a-538, as amended by P.A. 97-268 (H. 6266), L. 1997).
DEADLINES
An election to continue coverage must be made to the employer in accordance with the requirements of COBRA (Sec. 38a-538, as amended by P.A. 97-268 (H. 6266), L. 1997).
PENALTIES
Conversion coverage.- An employer who, after timely receipt of a premium from an employee, fails to make payment to the insurer will be liable for benefits. In addition, an insurer's failure to comply with conversion coverage requirements may result in a fine of not more than $500 (Sec. 38a-548).
<p>Conversion coverage.— An employer who, after timely receipt of a premium from an employee, fails to make payment to the insurer will be liable for benefits.</p>