Written by a parent, not a doctor. Nothing here is medical advice.

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Federal, exists in every state

Keeping work coverage through COBRA or New York continuation

Federal right to keep the same group plan, usually for 18 months, at the full premium plus up to 2%.

What it is

Federal right to keep the same group plan, usually for 18 months, at the full premium plus up to 2%.

If work coverage ends, federal COBRA usually continues it for 18 months. New York continuation can reach 36 months total on eligible insured plans, including small-employer plans. Premiums can reach 102% of the plan’s cost. HR and the insurer can confirm coverage loss, plan type and the actual premium.

Rules
  • Federal COBRA generally applies at employers with 20 or more employees, subject to employer-type and counting rules.
  • For federal COBRA, the election period is at least 60 days after coverage loss or the notice, whichever is later. The first payment is due 45 days after election. Later premiums have at least a 30-day grace period. Coverage is retroactive once the required premiums are paid. New York state-only continuation has separate payment rules below.
  • Voluntarily cancelling the work plan usually does not open a marketplace enrollment window.
What you get
  • Continued employer coverage when you elect it and pay the premiums within the required deadlines.
  • A New York continuation review even when the employer is too small for federal COBRA.
Cost
  • Up to 102% of the plan’s cost; employer contributions usually end but can be subsidized. Ask for the actual figure.
If you decide to apply
  1. Ask HR whether coverage is changing and, if so, the exact end date and the COBRA election notice.
  2. Ask for the full monthly premium in writing.
  3. Have the hospital compare treatment access under COBRA, Medicaid and a NY State of Health plan before choosing.

Department of Labor: COBRA · Official page ↗

Deadlines
  • Do not let the election window pass while waiting on another option; you can elect and later drop it.
Good to know

A job change alone does not prove insurance is ending. Get the end date in writing first.

New York continuation: small employers and payment deadlines
  • New York continuation can cover an insured small-employer group and can extend eligible insured group coverage to a total of 36 months, generally at up to 102% of the group premium. The state election period is 60 days after the later of coverage ending or the required notice. State-only continuation has its own first-premium rule: §4305(e)(3) links the written election and first payment to 60 days after benefits would terminate, while §4305(e)(2) gives a later-notice election period. That interaction should be checked with the insurer or DFS on a late notice; do not assume federal COBRA’s separate 45-day first-payment allowance applies. For federal COBRA, that 45-day initial allowance and the required grace period for later premiums remain separate federal protections.
  • Continuation follows the coverage available to active employees. Confirm the current network, treatment approvals and premium dates before choosing.

Related New York card: Replacement insurance through NY State of Health.

Official sources
Ask your social worker

“If our work coverage ends, can you help us compare keeping the plan through COBRA with Medicaid and a NY State of Health plan before the deadline?”

Why I’m asking: Keeping our child’s care team matters, and we need the full premium and dates to decide.

More background and detailed requirements
Additional program information and published rules

Who does what

The three parts, side by side. The agency decides; nobody on this page does.

You

Ask for the election notice, elect within 60 days, pay within 45 more, and keep proof of every payment.

Your social worker

Helps you compare continuity of treatment against the premium and the other coverage options.

The care team

Records and letters when the application asks for them.

Who decides
The plan's COBRA administrator
Ask HR
“Is our plan under federal COBRA (20 or more employees) or state continuation? When will the election notice go out, what is the full monthly premium, and what is the last day to elect?”

How to apply

First step: Ask human resources for the COBRA election notice in writing the day the job ends, and write the 60-day date on the calendar.

  1. Ask HR for the election notice in writing the day the job ends.
  2. Write the 60-day date on the calendar.
  3. Compare with the Marketplace period and Medicaid before paying.

Where it starts: Election notice from the employer. DOL EBSA 1-866-444-3272 for help

What to gather

  • The election notice with the premium and the coverage-end date
  • Employer size
  • Whether the plan is fully insured or self-funded

How long: The notice usually arrives within a few weeks of the job ending. Coverage is retroactive to the loss date once you elect and pay.

Clock: Elect COBRA within 60 days of the later of losing coverage or getting the election notice.

Clock: Make the first payment within 45 days of electing, covering every month back to the loss.

What a yes looks like

Confirmation of continued coverage with the paid-through date. The hospital sees no gap.

What a no looks like, and the next move

“Employer too small” or “late election”: ask the insurer about state continuation and use the 60-day Marketplace period.

Watch out

  • Federal COBRA applies to employers with 20 or more people. Smaller employers use state continuation rules, which often offer a shorter coverage period.
  • You have 60 days to elect and 45 more days to make the first payment. You can wait and elect retroactively, but then every back premium is due at once.
  • Dropping COBRA voluntarily or missing a payment does not open a new Marketplace period.
  • Federal employees have Temporary Continuation of Coverage rather than ordinary private-employer COBRA: event-specific duration and election rules apply. Ask the employing office for the TCC notice and premium.

The numbers and the rules

The arcane layer, kept on purpose. Checked September 10, 2026.

What it is worth

The same plan, network and deductible progress for 18 months (29 with a disability extension, 36 for some family events), at up to 102% of the full premium.

  • $102/month (150% only in disability-extension months 19–29) — Maximum premium charge
  • $45 — Days to make the first payment after electing

Legal protection: Continuation of the same group plan after a qualifying event · 60-day election from the later of the coverage loss or the election notice · 30-day grace period for each later payment

What it costs the family: The employer subsidy usually ends. The family pays up to 102% of the full premium.

The eligibility facts, as published

Employer size min
20
Qualifying event
job loss or reduction of hours (not gross misconduct)
Election days
60
First payment days
45
Grace days
30
Durations months
18; 29; 36
Premium max percent
102
Disability extension premium percent
150

Decisions this site cannot make: COBRA applicability (employer size, plan, event)

Expect friction on: Short period · High premium

The trap: Federal COBRA applies to employers with 20 or more people. You have 60 days to elect and 45 more to pay. A retroactive election is lawful but every back premium is due at once.

What changes by state: Small-employer continuation (“mini-COBRA”) length and premium. Ask the social worker for the contact.

Where I read this

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