COBRA Law Summaries

COBRA Law Summaries

District of Columbia, COBRA Law Summaries

The District of Columbia established the continuation of a person's eligibility for health insurance coverage when an employer maintains a health benefits plan for less than 20 employees. The law appears at Title 32, Chapter 7A.

WHAT THE EMPLOYER MUST DO

Employees have the right to continue coverage for themselves and their dependents under the employer's health benefits plan for a period of three months, or for the period of time during which the employee is eligible for premium assistance under the American Recovery and Reinvestment Act of 2009, approved February 17, 2009. The 65% premium subsidy under ARRA is generally available for nine months of coverage. The extension is temporary and expires June 14, 2009 (90 days after enactment) (Sec. 32-732(a), as amended by DC B 159, enacted and effective March 16, 2009). Health benefits plan means any accident and health insurance policy or certificate or HMO subscriber contract, or other benefit arrangement, such as a multiple employer welfare arrangement. It does not mean accident only, credit or disability insurance or coverage of Medicare services, for example.

Employees who have been terminated for gross misconduct or those who are eligible for federal COBRA coverage (those working for employers who have 20 or more employees) are not eligible for continuation of coverage under this law, nor are those who fail to complete a timely election and payment. Once the election is made, an individual must send payment of the required amount to the employer no later than 45 days after the date coverage would otherwise terminate.

The covered individual's cost for continued coverage cannot exceed 102 percent of the group rate.

The employer must furnish the employee whose coverage is terminated with a written notification of the existence of the right to continue coverage. The notification shall be furnished not later than 15 days after the date that coverage under the health benefits plan would otherwise terminate. Failure by an employer to furnish the notification does not extend the right to coverage beyond the time provided by the law.

Coverage must continue without interruption unless the individual establishes residence outside of the health insurer's service area, fails to make timely payment, violates a material condition of the contract, becomes covered by other group health benefits (without preexisting condition limitations), becomes entitled to Medicare, or the employer no longer offers health benefits coverage to any employee (Sec. 32-732, effective June 25, 2002).

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District of Columbia, COBRA Law Summaries

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