Group underwriting, federal COBRA, HIPAA and the ACA group rules are covered in the national Group Health Insurance guide. Nebraska adds a state continuation law for employers too small for COBRA, and a separate continuation right for surviving spouses (Neb. Rev. Stat. 44-1639 to 44-1645). This guide covers those rules and Nebraska's group eligibility rules.

Eligible groups (44-760)

For Nebraska's small-group law, a small employer has at least two and no more than 50 eligible employees (44-5253).

State continuation for small employers (44-1640 to 44-1642)

• Who it covers. Employer group plans whose size means they're not subject to federal COBRA (Internal Revenue Code section 4980B).
• Who qualifies. An employee whose coverage ends because of involuntary termination for reasons other than misconduct connected with the job.
  • A gap caused by a labor dispute isn't an involuntary termination.
• Notice and election:
  • The employer sends notice by certified mail, return receipt requested, within 10 days after termination.
  • The employee returns the election form and first monthly premium by certified mail within 10 days after receiving the notice.
• Cost. No more than 102% of the total group premium, paid by the former employee.
• Length. Coverage lasts until six months after it would otherwise have ended, or sooner if another listed event occurs.

Surviving spouse continuation (44-1643 to 44-1645)

• Who it covers. When a covered employee dies, the surviving spouse may continue group coverage.
• Notice and election:
  • The employer's notice is due within 10 working days of the death.
  • The election form and first premium are due within 31 days after the date of death.
• Length. Up to one year after coverage would otherwise end.
• Continuation ends sooner when the spouse:
  • remarries
  • becomes eligible for other group coverage
  • becomes eligible for Medicare or is covered by Medicaid
  • doesn't pay the premium

Related group rules

• Group life conversion and continuation rules are in the Nebraska Types of Life Insurance guide.
• Group and blanket plans may have rates and benefits that differ from individual plans, but they still can't unfairly discriminate between people of substantially the same hazard (44-749).

Common exam traps

• Nebraska's small-employer continuation lasts only six months, at up to 102%.
• It applies only to employers not subject to federal COBRA, and only after involuntary termination not for misconduct.
• The notice and the election each run on 10-day deadlines by certified mail.
• Surviving spouse continuation lasts up to one year and ends on remarriage.