North Dakota program
Keeping a small employer’s plan after a job ends
A way to continue a qualifying North Dakota insured group health policy after employment ends, especially when federal COBRA is unavailable.
What it is
A way to continue a qualifying North Dakota insured group health policy after employment ends, especially when federal COBRA is unavailable.
Keeping the same plan may preserve access to the treatment team while you compare options. North Dakota’s continuation law is especially relevant at employers with fewer than 20 employees. Short request and payment deadlines matter.
Eligibility rules
- The group policy must be insured and issued or delivered in North Dakota. At least three months of continuous prior coverage is required.
- A written request is due within 10 days after the later of termination or notice, subject to a 31-day outside deadline after termination. Election and the first payment must fit the applicable deadline.
- This is for a qualifying North Dakota insured group policy after at least three continuous months of coverage. The written request is due within ten days after the later of employment termination or receipt of notice, but the statute also sets an outside limit of 31 days after employment termination. Election and the first premium have a separate 31-day deadline measured from when coverage would otherwise end. Late notice needs review by the insurer, Insurance Department or legal counsel; an extension of the outside limit is not promised. Ordinary private self-funded plans are not covered by this state insurance mandate; an insured government plan is not automatically excluded merely because it is governmental.
What you get
- Up to 39 weeks of continued group health coverage.
- The premium cannot exceed the group rate, but you pay the whole amount.
What the help includes
- Premiums are paid monthly in advance to the employer. Medicare coverage bars this continuation.
If you decide to apply
- Ask the employer or group policyholder for the continuation terms and forms in writing.
- Have the termination date, notice date, plan details and premium amount ready to compare.
The employer or group policyholder · Official page ↗
After you ask
- Coverage may end before 39 weeks for nonpayment or when the group policy ends.
Good to know
Dental, vision and prescription benefits do not have to continue. That can matter greatly during cancer treatment.
Other details
- Federal COBRA and HealthCare.gov may be alternatives. The comparison includes total premiums, medicines and continued access to the cancer team.
Official sources
“If our work plan ends, could state continuation keep our child’s treatment covered? What benefits would drop and what would it cost, and could you help us compare before choosing?”
Why I’m asking: I want to avoid a treatment gap without committing to coverage that leaves out medicines.
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
A written request is due within 10 days after the later of employment termination or notice receipt, no later than 31 days after employment termination. Election and the first premium have a separate 31-day deadline from when insurance would otherwise end. A late notice does not establish an extension.
Your social worker
HR sends the election paperwork and takes the payment.
The care team
Records and letters when the application asks for them.
- Who decides
- The employer or group policyholder.
- Ask HR
- “I am asking in writing for North Dakota state continuation of our group health plan. What is the monthly premium and where do I send the first payment?”
How to apply
First step: Write to the employer the week the job ends and ask for North Dakota state continuation by name.
- Ask HR in writing for state continuation the week the job ends.
- Election and first-premium receipt have a 31-day deadline from the date coverage would otherwise end.
- Ask what the continued plan does and does not include.
Official application / program page ↗
Where it starts: A written request is due within 10 days after the later of employment termination or notice receipt, no later than 31 days after employment termination. Election and the first premium have a separate 31-day deadline from when insurance would otherwise end. A late notice does not establish an extension.
What to gather
- The termination notice and its date
- The plan name and member numbers
- The premium amount
How long: Cover runs up to 39 weeks from the date the plan would otherwise have ended.
Clock: Ask the employer in writing within 10 days of the later of the job ending or the notice, and in no case more than 31 days after the job ends.
What a yes looks like
A continuation notice and an invoice for the monthly premium.
What a no looks like, and the next move
Often the deadline or the three-month prior-cover rule. Ask which it was, and ask about HealthCare.gov within 60 days.
Watch out
- A written request is due within 10 days after the later of employment termination or notice receipt, no later than 31 days after employment termination. Election and the first premium have a separate 31-day deadline from when insurance would otherwise end. A late notice does not establish an extension.
- Dental, vision and prescription cover do not have to be carried over. Ask what stays.
The numbers and the rules
The arcane layer, kept on purpose. Checked September 11, 2026.
What it is worth
Up to 39 weeks of qualifying insured group coverage, paid monthly in advance at no more than the group rate.
- $39 — Maximum duration
- $3 — Continuous cover needed immediately before the job ended
- $10 — Written request deadline after the later of termination or notice
- $31 — Outside written-request deadline after employment termination; election and first premium separately run 31 days from coverage ending
Covers: The same insured group health plan, continued
Legal protection: The premium cannot be more than the group rate
What it costs the family: You pay the whole premium to the employer, monthly in advance.
The eligibility facts, as published
- Employer size
- not confined by the statute to small employers; compare the qualifying insured policy with federal COBRA
- Prior coverage
- continuously insured under the group policy for the three months immediately before termination
- Plan type
- insured group policies issued or delivered in North Dakota; self-funded and government plan reach was not established
- Statute
- NDCC 26.1-36-23
The trap: A written request is due within 10 days after the later of employment termination or notice receipt, no later than 31 days after employment termination. Election and the first premium have a separate 31-day deadline from when insurance would otherwise end. A late notice does not establish an extension.
Where I read this
- Century Code chapter 26.1-36, Accident and Health Insurance — North Dakota Legislative Council, read September 10, 2026
- Health FAQ — North Dakota Insurance and Securities Department, read September 10, 2026