How group coverage works is covered in the national Group Health Insurance guide: master policies, certificates, eligibility, experience rating, coordination of benefits, and federal COBRA. Massachusetts adds two continuation laws. Small-group continuation under c.176J s.9, often called mini-COBRA, covers employers too small for federal COBRA. Chapter 175 s.110G covers layoffs, deaths and plant closings. Massachusetts also has rules for divorced spouses and for people who leave the group.

Small-group continuation (c.176J s.9)

Who it applies to. Small-group plans with 2 to 19 eligible employees. Plans with one employee, or more than 19, are excluded.

How long:

• 18 months after loss of coverage from termination of employment or reduced hours
• 36 months for most other qualifying events
• 29 months for a beneficiary determined to be disabled at the time of a job-loss event, with proper notice

Cost. No more than 102% of the applicable premium. The cap rises to 150% after month 18 in a disability extension.

Election. The election period lasts at least 60 days.

Continuation under c.175 s.110G

• Involuntary layoff or death. Coverage may continue for 39 weeks, or until the person becomes eligible under another group plan if that comes first. The member pays the whole premium, including the employer's former share.
• Plant closing. Coverage continues for up to 90 days after a plant closing or covered partial closing. The employee pays only the usual employee share.

Other Massachusetts group rules

• Leaving the group (s.110D). A person who leaves the group stays insured for 31 days, unless entitled to similar benefits elsewhere.
• Divorce (s.110I). A former spouse stays eligible under the member's group coverage, without extra premium, until either one remarries or until the time set in the divorce judgment, whichever is earlier.
• Contributory plans (s.110). A contributory group policy offered to all eligible employees must insure at least 75% of them.
• Coordination of benefits (211 CMR 38). For a child covered under both married parents' plans, the plan of the parent whose birthday falls earlier in the year is primary.
• Small business (c.176J s.1). For small-group rating and availability, a small business has 1 to 50 eligible employees, and full time means 30 hours a week. Plans can't exclude anyone for health condition or claims experience.

Common exam traps

• Small-group continuation applies to employers with 2 to 19 employees.
• It lasts 18 months for job loss, 36 for other events, and 29 with a disability extension. The premium is capped at 102%, and the election period is at least 60 days.
• After a layoff or death, s.110G continuation lasts 39 weeks at the full premium. After a plant closing, it lasts 90 days at the employee share.
• A former spouse stays covered until remarriage.
• Contributory plans must enroll at least 75% of eligible employees.