Health Benefits Advisor

Employer Has Fewer than 20 Employees

Your employer, employee organization (such as a union), or both are not required to offer you and your family the opportunity to elect COBRA continuation coverage if the employer did not have 20 or more employees in the prior calendar year.

However, you should know that there are other options available that may assist you and your family members in obtaining health coverage. For example, you and your family members may have special enrollment rights in a plan sponsored by your spouse's employer or union or in another group health plan. Or, you may have rights under state law to continuation coverage which may be similar to COBRA continuation coverage. Or, you may also be eligible for Medicaid, Medicare, CHIP (Children's Health Insurance Program) or other health coverage.

In choosing among the options available to you, you should review the SPD (summary plan description) for each available group health plan to determine which plan best meets your needs. You should also review and compare the information on the other coverages for which you are eligible. In making your decision, you may want to consider such things as:

1. Any waiting period (or affiliation period) imposed under the plans;
2. Types of benefits offered (Is dependent coverage available? Do the benefits cover your family's medical needs?);
3. Cost of coverage (premiums, co-payments and deductibles for prescription drugs and doctor visits);
4. Limitations on coverage; and
5. Any exclusions from coverage (treatments, procedures, conditions or prescription drugs).

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