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Health Care Continuation (COBRA): Federal

Health Care Continuation (COBRA) requirements by state

Author: Jayne Zanglein, Western Carolina University


  • Employers with at least 20 employees are required to comply with the Consolidated Omnibus Budget Reconciliation Act (COBRA). See Continuation of Health Care Coverage.
  • COBRA requires group health plans to extend health insurance coverage to employees and their families who lose coverage due to certain qualifying events. See Qualified Beneficiaries; Qualifying Events.
  • Employees terminated for gross misconduct are generally not eligible for COBRA coverage. See Termination for Gross Misconduct.
  • Employers are required to provide employees and their families with notices explaining their rights to COBRA continuation coverage. See Required COBRA Notices.
  • Coverage offered under COBRA must be the same as the coverage extended to individuals who are not receiving continuation coverage under COBRA. See Benefits Offered Under COBRA.
  • COBRA coverage is for a limited length of time, generally 18 months. See Period of Continuation Coverage.
  • Certain conditions entitle covered individuals to extend the 18-month maximum period of continuation coverage. See Extension of Continuation Coverage.
  • Covered participants pay the full cost of coverage at the group rate. Employers can charge a two percent administration fee. See Paying for COBRA Coverage.