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Health insurance continuation coverage — Missouri

Coverage under the Consolidated Omnibus Budget Reconciliation Act

The Consolidated Omnibus Budget Reconciliation Act (COBRA) is a federal law which requires that most employers extend group health plan privileges to employees who would otherwise lose coverage.

All employers who maintain a group health plan are subject to COBRA rules unless either:

  • The employer employed fewer than 20 employees (counting full-time and part-time) on at least 50% of its typical business days during the previous pay period. Part-time employees are counted as partial employees. Also, for purposes of the 20-employee threshold, employees of all companies that are in a controlled group with the employer must be counted.
  • The employer is the federal government or certain church-related organizations. (However, governmental employers may be subject to similar rules under the Public Health Services Act.)

Coverage under Missouri's "mini-COBRA" Law

Because small employers are not subject to COBRA, many states, including Missouri, have enacted “mini-COBRAs,” designed to protect those employed by smaller businesses that may lose group health plan coverage. These mini-COBRAs are state COBRA expansions that extend coverage to...


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