Continuation of Benefits Coverage (COBRA) - South Carolina

Summary of differences between federal and state regulations

Federal COBRA applies to employers who offer group health plans, and have 20 or more employees, but state laws may also apply. State law includes the following provisions:

• A group policy issued for delivery or renewed, which provides hospital, surgical, or major medical expense insurance, or any combination of these coverages, on an expense incurred basis must provide that an employee who has been insured continuously under the group policy for at least six months whose insurance under the group policy has been terminated for any reason other than nonpayment of the required contribution is entitled to continue coverage under the group policy for the fractional policy month remaining at termination plus six additional policy months. (38-71-770)
• The employee is not entitled to have his coverage continued if the employee was entitled under federal law to continuation of his coverage for a period of greater duration than provided by state law. (§38-71-770)
• The employer must clearly and meaningfully advise an employee upon termination of the right to continue insurance and must advise the employee of the amount of premium required and of the employee's responsibility to pay the premium each month before the date that the policy month begins. (§38-71-770)
• Employees are not entitled to continue coverage under the group if eligible for other group coverage which provides similar benefits, nor if they are eligible for Medicare benefits provided by Title XVIII of the United States Social Security Act. (§38-71-770)

State

Contact

South Carolina Department of Insurance

Regulations

South Carolina Code

Title 38 Insurance

Chapter 71 Accident and Health Insurance

§38-71-770 Mandatory continuation and conversion privileges

Federal

Contact

Employee Benefits Security Administration (EBSA)

Regulations

26 CFR 54.4980B-1 et seq.