​Mini-COBRA, or Act 2 of 2009, is a Pennsylvania law that gives employees of small businesses (2-19 employees) who receive health insurance from their employers the right to purchase continuation health insurance after they leave employment. It allows eligible employees and dependents to purchase health insurance through their former employer for nine months after their employment ends.

​Mini-COBRA is modeled after the federal COBRA law, but with some important differences. The federal COBRA law allows employees at larger businesses (20 or more employees) to purchase continuation health coverage after they leave employment for 18 months (or, in some cases, 36 months) after their employment ends. Pennsylvania's Mini-COBRA applies to employees of smaller businesses (2-19 employees) and it is for a shorter length of time (9 months, with no extensions).

​Covered employees and their eligible dependents who lose group health insurance coverage through a small employer as a result of a "qualifying event" are eligible for Mini-COBRA continuation coverage. The covered employees and eligible dependents must have been continuously insured under the group policy, or for similar benefits under any group policy which it replaced, for three consecutive months ending with the employee's termination.

Certain people are not eligible for Mini-COBRA.  Mini-COBRA continuation coverage is not available for anyone who:

• Is covered or is eligible for coverage under Medicare.
  

• Fails to verify that they are ineligible for employer-based group health insurance as an eligible dependent.

• Is or could be covered by any other insured or uninsured group health coverage arrangement and under which the person was not covered immediately prior to such termination.  (This does not include Medical Assistance, also known as Medicaid, or CHIP, the Children's Health Insurance Program.  If a person is eligible for either of those programs, but not enrolled, that does not prevent them from being eligible for Mini-COBRA.)
  

​A qualifying event is an event that would result in the loss of coverage for the covered employee or eligible dependent, including:

• Death of the covered employee.
• Termination of employment (either voluntary or involuntary, but not for the employee's gross misconduct).
• Reduction in hours.
  
• Divorce or legal separation.
• Covered employee's eligibility for Medicare.
• Dependent child ceasing to be dependent.
• Bankruptcy of the employer. 

​No, an employee or dependent who is eligible for Mini-COBRA coverage may not be discriminated against on the basis of any evidence of lack of insurability.

​No. You are no longer eligible for Mini-COBRA if you are eligible for Medicare or another group plan.

​You may choose to enroll in coverage through Pennie^® instead of Mini-COBRA. Keep in mind that with Mini-COBRA, you may have to pay an administrative expense on top of your premium.  Also, most people who enroll in coverage through Pennie^® are eligible for financial assistance to lower their monthly premium, and some are also eligible for additional financial assistance to lower their out-of-pocket health care costs. 

​No.  If you are on Mini-COBRA, you may only switch to Pennie® coverage during the Open Enrollment Period, typically between November 1 and January 15, or if the cost of your Mini-COBRA coverage changes.

​Yes.  If you are on Mini-COBRA and your period of coverage overlaps with Pennie's Open Enrollment Period, you may switch to a plan through Pennie.  However, you may only make this switch during the Pennie^® Open Enrollment Period.

​Yes.  There are two special situations when you would be eligible for a Special Enrollment Period:

1. If your Mini-COBRA costs change, such as if your former employer stops contributing to your premium. 

2. If your nine months of Mini-COBRA coverage ends after Pennie's Open Enrollment Period.
   

​Yes.  If you are covered by Mini-COBRA and your employer replaces its group policy with another policy, you will continue to have coverage under the new policy.  However, the details and cost of the coverage may change.

​Not necessarily. The Mini-COBRA law looks to the insurance policy, rather than the type of employer and the employer's benefit plan. An employer's insurance policy is subject to Mini-COBRA if: (1) the employer has an insurance policy (not a self-funded plan) that insures employees and eligible dependents for hospital, surgical or major medical benefits; (2) the persons eligible for Mini-COBRA benefits are not subject to COBRA; and (3) the employees are employed by an employer that normally employed between 2 and 19 employees on a typical business day.

​Coverage must be provided by the same employer. The term "replaced" refers to the type of policy the employer offers. For example, if an employer changes the group policy within that three-month period, and the employee was covered under the old policy and the replacement policy over the course of the three-month period, the employee or eligible dependent would still be eligible for Mini-COBRA coverage.

​Yes, an employee needs to be notified after a “qualifying event”.  See a list of qualifying events in the eligibility section above.

​When health coverage ends due to a "qualifying event", the employer must provide notice to the covered employee.

​Under the Mini-COBRA law, an employer must give notice of a "qualifying event" – to the plan administrator (if different than the employer), the covered employee, and the insurance company – within 30 days of the "qualifying event".

​Yes. The Insurance Department and the Department of Labor & Industry developed a model notice available for employers and insurance companies to use in communicating options to employees.

​The Mini-COBRA law does not specify how notices must be provided, but it is prudent for an employer or insurance company to maintain proof of mailing in the event of any dispute about the timing or receipt of the notice. It is also prudent for an employee to record when they received the notice.

​No, a change in the employer's benefit plan is not a qualifying event for Mini-COBRA coverage. 

​There are no specific penalties laid out in the Mini-COBRA law. However, to the extent any person or entity is performing activities in the business of insurance, such as issuing or administering an insurance policy, it is subject to applicable penalties in the Pennsylvania insurance laws. Employers also may be subject to penalties by the Department of Labor & Industry or by the federal Department of Labor.

​You (or your dependent) must give notice to the administrator (who may be your employer) of your election within 30 days of receiving notice of the qualifying event. 

​Once the administrator receives notice from you (or your dependent) that you are electing Mini-COBRA, the administrator must in turn give notice to the insurance company of the election within 14 days of the election.

​There will be no break in coverage. The continuation coverage will begin as of the date the prior group coverage ended. 

​Mini-COBRA may cost as much as 105% of the group rate for the insurance.  This amount would be 100% for the coverage itself, plus up to 5% additional for administration of the Mini-COBRA coverage.  An employer, or whoever administers the coverage, may choose to charge less than the full 105%.

​Yes, the continuation coverage must include any benefits provided under the group medical policy.

​No, the Mini-COBRA law only requires continuation of medical insurance.

​Anyone covered under Mini-COBRA must pay for the coverage on a monthly basis.  Your payment should coordinate with the timing of your former employer's regular payments to the insurer for the group insurance that is being continued so that the employer has your payment prior to the employer's "due date of each payment." 

​The grace period for premium payments under Mini-COBRA is not specified in the act but would be the same as under the group coverage being continued.

The Mini-COBRA law does not exclude medical spending accounts. However, if your former employer has made all scheduled payments prior to the termination of your employment, the employer has no ongoing requirement to contribute to the account.  For purposes of determining whether the employer has made all scheduled payments, the employer must satisfy all rules, including comparable contribution and nondiscrimination rules, applicable to the medical spending account.

Note: Any employer funding its employees' medical spending accounts on an irregular basis should look carefully to ensure that it is satisfying all laws applicable to the spending accounts, since funding on an irregular basis may run afoul of comparable contribution and nondiscrimination rules, and possibly other rules as well.

​No.  Unlike COBRA, the Mini-COBRA law does not have any provisions for extensions.  However, you will be eligible for a Special Enrollment Period for coverage through Pennie^®.