The national guide covers group underwriting, master contracts and certificates, federal COBRA, coordination of benefits and conversion. Florida adds a small-employer continuation law (the Florida Health Insurance Coverage Continuation Act), conversion and extension-of-benefits rules, a dependent-age option to 30, and statutory coordination-of-benefits rules.

State continuation (627.6692)

• Who it covers: employees of employers with fewer than 20 employees.
• Length: up to 18 months. A disability extension adds 11 months, for 29 months in total.
• Cost: up to 115% of the group premium, or up to 150% during the disability extension.
• Election: in writing, within 30 days after the carrier's notice.

Conversion and extension of benefits

• Conversion (627.6675): a person insured for at least three months can convert to individual coverage without proof of insurability. The application and first premium are due within 63 days of termination. HMO members have the same 63-day window (641.3922).
• Extension of benefits (627.667): a person totally disabled when the group coverage ends keeps benefits for that condition:
  • 12 months for major medical
  • 90 days for other hospital and medical coverage

Eligibility and renewal

• Master policy goes to the employer or sponsor. Members get certificates (627.652).
• Health status: eligibility rules can't be based on health status, medical condition, claims experience, genetic information or disability (627.65625).
• Dependents: covered to the end of the year they turn 25, and group plans must offer coverage to 30 for unmarried, uninsured Florida residents or students (627.6562).
• Renewal: group coverage renews except for listed reasons, such as nonpayment, fraud, failing participation or contribution rules, or market withdrawal (627.6571).
• Small employers: 1 to 50 employees. An eligible employee works at least 25 hours a week. Small-group coverage is guaranteed issue and guaranteed renewable (627.6699).
• Franchise health: 2 or more employees of one employer, or 10 or more members of an association or union (627.663).
• Blanket health covers groups such as common-carrier passengers, students and teachers, and volunteer fire and first-responder groups (627.659).

Coordination of benefits (627.4235)

• The plans together pay 100% of reasonable covered expenses.
• The plan that covers a person as an employee pays before a plan that covers the person as a dependent.
• Birthday rule: for a child covered by both parents, the plan of the parent whose birthday (month and day) comes first in the year pays first.

Exam traps

• Florida mini-COBRA: fewer than 20 employees, 18 months (29 with disability), 115% premium (150% during the extension).
• Conversion: insured at least 3 months, apply within 63 days.
• Dependents to 25, with an option to 30.
• Small-group eligible employee: 25 hours a week.