Both South Carolina law and the federal Consolidated Omnibus Budget Reconciliation Act (COBRA) permit employees to continue their group health coverage if they leave the group for certain specified reasons. According to federal law, when comparing state and federal continuation rights, employees may use the law that is more favorable to their situation. South Carolina law applies to insured plans sponsored by all employers, regardless of size, but provides shorter continuation in fewer circumstances than does federal COBRA (SC Code Ann. Sec. 38-71-770). Unlike federal COBRA, South Carolina's continuation requirement applies to plans providing hospital, surgical, or major medical coverage only.
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Download Now The South Carolina requirement covers group insurance policies of all employers that provide hospital, surgical, or major medical coverage, or any combination of these coverages. An employee who has been insured continuously under the policy for at least 6 months and whose coverage has been terminated for any reason other than nonpayment of the required contribution is entitled to continue coverage under the group policy for the part of the policy month remaining at termination plus 6 additional policy months. This coverage is not available if the employee is entitled to longer coverage under federal COBRA or is eligible for Medicare. Continuation of coverage is subject to the group policy or a successor policy remaining in force and the employee paying the entire group premium for any month, including any portion usually paid by the former employer, in advance.
Notice of the right to continue coverage after termination must be included in each certificate of coverage. In addition, the employer is required to ...