State Continuation Coverage

State continuation coverage is a state-mandated program that lets you temporarily keep your employer-sponsored health insurance after you lose it, similar to federal COBRA, but with different eligibility rules and often broader access.

While COBRA applies to employers with 20 or more employees, many states have "mini-COBRA" laws that extend continuation rights to employees of smaller companies. If your employer has fewer than 20 workers and you lose your job, COBRA wouldn't cover you, but your state's continuation law might.

The details vary significantly by state: duration ranges from 18 to 36 months depending on the qualifying event and state law, and some states offer continuation to groups that COBRA doesn't cover (like employees of very small businesses or employees who worked fewer hours than COBRA requires).

Like COBRA, state continuation coverage allows you to keep the exact same plan you had through your employer. The trade-off is cost: you typically pay the full premium (the employer share plus your former employee share), plus a small administrative fee. This can be expensive, since your employer was likely paying 50%–80% of the premium while you were employed.

State continuation coverage is a bridge, not a long-term solution. It keeps you covered while you transition to a new job with benefits, a Marketplace plan, or another option. Losing employer coverage is a qualifying life event for the Marketplace, so you can also shop for a potentially more affordable plan with premium tax credits during your 60-day Special Enrollment Period.