COBRA Law Summaries
Virginia, COBRA Law Summaries
Virginia's health care continuation law is codified in the Code of Virginia at Title 38.2, Chapter 35, Section 38.2-3541.
COVERAGE
Virginia's health care continuation law covers all employers maintaining group medical policies (Sec. 38.2-3541).
Continuation following involuntary termination of employment; special circumstances. The provisions of this section only apply to employees of small employers whose group health insurance coverage does not provide for continuation of coverage under the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) (Sec. 38.2-3541.1 (B), as added by H. 2024, L. 2009, enacted and effective April 8, 2009).
PROCEDURES
An employer must offer continuation coverage to an employee who has been continuously insured under the group policy during the entire three-month period prior to termination of coverage for any reason. Employees eligible for replacement group coverage upon termination are not eligible for continuation coverage (Sec. 38.2-3541)
The application for continuation coverage must be made to the group policyholder and the premium for the entire period of continuation coverage must be paid prior to termination of coverage under the group plan (Sec. 38.2-3541)
Continuation following involuntary termination of employment; special circumstances. Employees who are involuntarily terminated between September 1, 2008, and December 31, 2009, shall be offered the option to continue their existing group health insurance coverage (Sec. 38.2-3541.1 (A), as added by H. 2024, L. 2009, enacted and effective April 8, 2009).
WHAT THE EMPLOYER MUST DO
Virginia's health care continuation law requires an employer to offer continuation coverage to an employee who has been continuously insured under the group policy during the entire three-month period prior to termination of coverage (Sec. 38.2-3541).
Eligibility requirements.- An employee who has been continuously insured under the group policy during the entire three month-period prior to termination of coverage for any reason is eligible for continuation coverage. Employees eligible for replacement group coverage upon termination are not eligible for continuation coverage (Sec. 38.2-3541).
Continuation following involuntary termination of employment; special circumstances. Employees who are involuntarily terminated between September 1, 2008, and December 31, 2009, shall be offered the option to continue their existing group health insurance coverage. Coverage shall continue for up to nine months following (i) involuntary termination for those terminated on or after the date of enactment of this section (April 8, 2009) or (ii) following the date of the notice required below, contingent upon the involuntarily terminated employee's eligibility for premium assistance under the American Recovery and Reinvestment Act (Sec. 38.2-3541.1(A), as added by H. 2024, L. 2009, enacted and effective April 8, 2009).
Disability of dependent child.- If a group health plan specifies that a dependent child's coverage must terminate upon that child's attainment of a specified age, the attainment of that age will not operate to terminate the coverage of the child while the child is incapable of self-sustaining employment by reason of mental or physical disability and chiefly dependent upon the employee for support and maintenance. Proof of disability and dependency must be furnished by the employee within 31 days of the child's attainment of the specified age and thereafter, as required by the insurer, but not more frequently than annually after the two-year period following the child's attainment of the specified age (Sec. 38.2-3409).
Conversion to individual policy.- All employees and covered dependents whose group coverage is terminated for any reason are eligible for conversion coverage, unless they are eligible for replacement group coverage at the time of termination, or unless overinsurance would result (Sec. 38.2-3541).
Deadlines.- Application for the converted policy must be made, and the first premium paid, within 31 days after termination (Sec. 38.2-3541).
Premiums.- The premium charged must be at the insurer's then customary rate applicable:
to such policies,
to the class of risk to which the person then belongs, and
to the person's age on the effective date of the policy
(Sec. 38.2-3541).
Duration of coverage.- Continuation coverage will last for 90 days following the date group coverage ends (Sec. 38.2-3541).
Continuation following involuntary termination of employment; special circumstances. Coverage shall continue for up to nine months following (i) involuntary termination for those terminated on or after the date of enactment of this section (April 8, 2009) or (ii) following the date of the notice required by subdivision 3, contingent upon the involuntarily terminated employee's eligibility for premium assistance under the American Recovery and Reinvestment Act (Sec. 38.2-3541.1(A), as added by H. 2024, L. 2009, enacted and effective April 8, 2009).
Premiums: Continuation coverage.- The premiums for continuation coverage must be at the insurer's current rate applicable to the group rate (Sec. 38.2-3541).
Continuation following involuntary termination of employment; special circumstances. Premium payments (i) may be paid on a monthly basis to the group policyholder and (ii) shall not exceed 102 percent of the insurer's current premium rate applicable to the group policy; (Sec. 38.2-3541.1 (A), as added by H. 2024, L. 2009, enacted and effective April 8, 2009).
Premiums: Conversion coverage.- The premium charged must be at the insurer's then customary rate applicable:
to such policies,
to the class of risk to which the person then belongs, and
to the person's age on the effective date of the policy
(Sec. 38.2-3541).
DEADLINES
Continuation coverage.- The application for continuation coverage must be made to the group policyholder, and the premium for the entire period of continuation coverage must be paid, prior to termination of coverage under the group plan (Sec. 38.2-3541)
Continuation following involuntary termination of employment; special circumstances. Employers shall provide notice of the availability of continuation as follows: (a) Notice shall be provided to those employees whose employment was terminated on or after September 1, 2008, and prior to February 17, 2009, in accordance with Section 3001 of the American Reinvestment and Recovery Act; (b) Notice shall be provided to those employees whose employment was terminated on or after February 17, 2009, and prior to the date of enactment of this section (April 8, 2009), no later than 60 days after April 8, 2009, or the employee's termination, whichever is later; and (c) Notice shall be provided to those employees whose employment was terminated after the date of enactment of this section (April 8, 2009) no later than 30 days following the date of the employee's termination. The employee shall elect this continued coverage no later than 60 days following notice of plan enrollment options (Sec. 38.2-3541.1 (A), as added by H. 2024, L. 2009, enacted and effective April 8, 2009).
Conversion coverage.- Application for the converted policy must be made, and the first premium paid, within 31 days after termination (Sec. 38.2-3541).
<p>Conversion coverage.— Application for the converted policy must be made, and the first premium paid, within 31 days after termination (Sec. 38.2-3541).</p>