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

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Pennsylvania program

Keep an insured work plan after coverage ends

Pennsylvania's small-employer continuation law can let you keep an insured work plan after coverage ends. You pay the premium yourself.

What it is

Pennsylvania's small-employer continuation law can let you keep an insured work plan after coverage ends. You pay the premium yourself.

State continuation can preserve the same insured work coverage after a qualifying event at a small employer. That may help keep treatment arrangements in place. The full premium can be expensive, so the comparison with Pennie and MA matters.

Eligibility rules
  • The plan must be insured and the employer must have between 2 and 19 workers.
  • A qualifying termination can include a quit. Gross misconduct and other statutory exclusions can block continuation.
  • The carrier also checks three continuous months of prior coverage, which family members were covered before the qualifying event, the reason coverage ended and any other coverage or Medicare eligibility. A child born or adopted during continuation has a specific rule. Medicaid or CHIP eligibility is not the same as the law’s other-group-coverage exclusion. Nonpayment, the end of the group policy or other statutory events can end coverage before nine months.
What you get
  • Up to nine months on the qualifying group plan.
  • The same group coverage while continuation remains available.
  • A premium of up to 105% of the group cost, paid by you.
What the help includes
  • The law can provide up to nine months of continued insured coverage. It does not require the employer to subsidize the premium.
  • The premium can be as high as 105% of the group rate, so the old payroll deduction may be much lower than the continuation bill.
If you decide to apply
  1. Ask the employer for the statutory continuation notice and the full monthly premium.
  2. Ask the carrier to confirm eligibility, the election date and payment dates.
  3. Compare the cost and treatment network with Pennie or MA before making the election.

Your employer’s benefits office and the insurance carrier · Official page ↗

After you ask
  • An election is due within 30 days after the statutory notice. Written carrier confirmation helps establish the continued coverage dates.
  • The employer has 30 days after coverage ends to send the notice, and you then have 30 days to choose. Coverage can reach back to the day the plan ended. Ask the insurer in writing for the first payment date and any grace period.
Good to know

The election deadline is 30 days after the statutory notice. The employer's group policy must stay in force.

Other details
  • Federal COBRA has different employer-size rules and timing. The employer or carrier can identify which continuation notice applies.
  • If the employer's policy ends, this state continuation route cannot keep that discontinued group contract operating.
Official sources
Ask your social worker

“Would Pennsylvania continuation let us keep this plan, and what would the full premium be? Could you help compare it with Pennie and MA and check the election and payment dates?”

Why I’m asking: Keeping the same treatment network may help, but I need to know whether we can afford the whole premium.

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 the employer for the statutory notice; elect within 30 days after that notice.

Your social worker

The hospital social worker helps locate the right office and gather supporting records.

The care team

Records and letters when the application asks for them.

Who decides
The agency or plan named in the first step
Ask your social worker
“Can you confirm state continuation, the premium, election deadline and whether the oncology network stays the same?”

How to apply

First step: Discuss the statutory continuation notice, full premium, dates and alternatives with the benefits office. If you choose continuation, the notice and carrier confirm election and payment requirements.

  1. Ask the employer for the statutory notice; elect within 30 days after that notice.

Where it starts: Ask the employer for the statutory notice; elect within 30 days after that notice.

What to gather

  • The relevant plan or benefit notice
  • Documents showing the need and relevant income

How long: Ask the deciding office for its current processing time.

What a yes looks like

Written confirmation of the benefit, its scope and any cost.

What a no looks like, and the next move

Ask for the reason in writing and the review route.

Watch out

  • A qualifying termination can include a quit, but gross misconduct and other statutory exclusions apply. The employer’s group policy must remain in force.

The numbers and the rules

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

What it is worth

Up to 9 months of continued insured coverage, subject to the law’s conditions.

Covers: Up to 9 months of continued insured coverage, subject to the law’s conditions.

What it costs the family: Ask the agency or plan to confirm any charge before committing.

The eligibility facts, as published

Plan
fully insured group plan
Employer size
2–19; the less-than-five questionnaire bucket does not distinguish one worker
Prior coverage
Confirm all statutory conditions with the carrier

The trap: The agency or plan checks the conditions; this guide does not decide the application.

Where I read this

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