Utah COBRA (Health Insurance Continuation) laws & HR compliance analysis

Utah COBRA (Health Insurance Continuation): What you need to know

Both Utah 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. Utah's mini-COBRA law covers all insured group health benefit plans regardless of the number of employees and provides for a shorter period of continuation (UT Stat. Sec. 31A-22-722). However, it does not apply to individuals eligible for federal COBRA continuation.
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Utah's mini-COBRA requirements provide that an employee and his or her covered spouse and dependents who have been continuously covered under a group policy for three months immediately prior to the termination of coverage may continue coverage under the policy for a period of 12 months when coverage is lost for the following reasons:
• Voluntary termination;
• Involuntary termination;
• Retirement;
• Death;
• Divorce or legal separation;
• Loss of dependent status;
• Sabbatical;
• Any disability;
• Leave of absence; or
• Reduction of hours.
An individual is not eligible to continue coverage under state law if he or she:
• Fails to pay any required individual contribution;
• Acquires other group coverage that covers all preexisting conditions, including maternity, if maternity coverage is provided;
• Commits fraud in connection with the coverage;
• Makes an intentional misrepresentation of material fact under the terms of the coverage;
• Is terminated for gross misconduct;
• Is eligible for continuation coverage under federal COBRA;
• Establishes residence outside of this state;
• Moves out of the insurer’s service area;
• Is eligible for similar coverage under another group insurance policy; or
• Has coverage terminated because the ...

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