Federal COBRA has a floor written into it. The U.S. Department of Labor’s own employee guide says COBRA “generally requires that group health plans sponsored by employers with 20 or more employees” offer continuation coverage. If you worked for a 12-person dental practice or a 6-person design studio, that sentence leaves you out.
State law is what fills the hole, and the same DOL guide points you there: “Many states have laws similar to COBRA or laws sometimes referred to as mini-COBRA, which apply to health plans maintained by employers with fewer than 20 employees. Check with your state insurance commissioner’s office to see if such coverage is available to you.” That last instruction is not boilerplate. These laws are genuinely different from one another, and the version in the state next door will not tell you anything useful about yours. Figures below are verified against state sources as of September 5, 2026.
What Mini-COBRA Is
Mini-COBRA is not one law. It is the nickname for roughly four dozen separate state statutes that require health insurers to keep a departing employee on the group plan for a set period, at a set price, when a qualifying event ends their coverage.
Three structural facts hold almost everywhere:
It is regulated by the state, not the Department of Labor. Massachusetts spells this out: COBRA is federal and is not enforced by the state Division of Insurance, while mini-COBRA is state law and is. Your complaint route is the state insurance department, not EBSA.
It only reaches fully insured plans. State insurance regulators have authority over insurance policies, not over employers who pay claims out of their own pocket. Texas puts it plainly: state continuation does not apply to self-funded plans since the state does not regulate them. Massachusetts says the same. Many small employers are fully insured, so this usually works in your favor, but ask.
The coverage itself is identical to what you had. It is the same policy, the same network, the same deductible you have already partly met. What changes is who writes the check.
Who Qualifies
The common pattern is straightforward. You were covered under a group health policy issued in your state, and you lost that coverage because of a qualifying event: layoff, reduction in hours, leave of absence, or termination for a reason other than gross misconduct. Spouses and dependent children are usually separate qualified beneficiaries with their own election rights, and events like divorce, death of the employee, or a child aging off the plan trigger their own (often longer) continuation periods.
Where states diverge:
- Employer size. Most states aim their law at the group federal COBRA misses. California requires the group to have had 2 to 19 eligible employees on at least half its working days. Massachusetts applies to plans issued to employers with 2 to 19 employees. New York covers employers with fewer than 20. Florida defines the small employer as one that “employs fewer than 20 employees.”
- Or no size limit at all. Connecticut’s law reaches “all fully insured group health insurance policies issued in Connecticut to employer group policyholders,” explicitly including groups both under and over 20 employees. Minnesota’s statute applies to every group policy, contract and health care plan except federal agency plans. Texas likewise runs alongside federal COBRA rather than only below it.
- Prior coverage requirements. Texas requires that you were covered for the three months before your job ended.
- Cause matters. Firing for cause generally disqualifies you. Texas notes you usually cannot get state continuation if you were fired, and Connecticut excludes termination for gross misconduct from continuation of any kind.
How Long It Lasts and What It Costs
Every figure in this table comes from that state’s own insurance department or statute. Where a state sets different periods for different qualifying events, the job-loss period is listed first.
| State | Employer size covered | Maximum duration | Premium cap |
|---|---|---|---|
| California (Cal-COBRA) | 2 to 19 employees | 36 months | 110% of the rate charged for a covered employee (150% for a disabled beneficiary after 18 months) |
| Connecticut | All fully insured groups, any size | 30 months for layoff, reduced hours, leave of absence or termination | 102% |
| Florida | Fewer than 20 employees | 18 months, or 29 with a Social Security disability determination | 115% of the applicable premium |
| Massachusetts | 2 to 19 employees | 18 months for job loss or reduced hours, 36 months for death, divorce, Medicare entitlement or loss of dependent status | 102% (150% during a disability extension past 18 months) |
| Minnesota | Every group policy issued in the state, any size | 18 months after termination or layoff | 102% |
| New York | Fewer than 20 employees | 36 months | 102% of the group rate |
| Pennsylvania | 2 to 19 employees | 9 months | Your old contribution plus the employer’s share, plus an administrative fee of up to 5% |
| Texas | State-regulated group plans, any size | 9 months if you are not eligible for federal COBRA, plus 6 months tacked on after COBRA ends if you are | The same premium charged for active employees, employer contribution included, plus 2% |
Look at the spread. The same job loss at a 10-person company produces 9 months of coverage in Pennsylvania and 36 months in New York, and costs 102% of the group rate in Minnesota and 115% in Florida. There is no federal floor underneath any of it.
Florida’s 115% is the highest cap in this table, and Pennsylvania’s nine months the shortest term. Neither is unusual enough to be a mistake in your paperwork, so do not assume an error if your notice looks stingy compared to what a friend in another state got.
On states with no law at all: a small number have no general continuation statute. Private trackers that publish state-by-state charts do not agree on which ones, and the lists have changed over time, so we are not going to name them from a source we cannot verify. The Department of Labor’s own phrasing is “many states,” not all. Call your state insurance department and ask directly.
Mini-COBRA vs. Federal COBRA vs. the Marketplace
Federal COBRA applies at 20 or more employees. It runs 18 months for termination or a cut in hours, 29 with a Social Security disability determination, and up to 36 months for other qualifying events. The premium is capped at 102% of the plan’s cost, or 150% during the 11-month disability extension. Full detail in COBRA insurance cost and how long COBRA lasts.
Mini-COBRA covers the same idea below that threshold, on terms your state picked. In some states it is more generous than federal COBRA (New York’s 36 months, Connecticut’s 30) and in others considerably less (Pennsylvania’s 9).
The marketplace is the third door, and the one people forget to price. Losing job-based coverage opens a 60-day special enrollment period, and marketplace savings are based on your projected income rather than your employment status, so a job loss usually improves your subsidy. Neither COBRA nor mini-COBRA has any subsidy attached.
The honest comparison looks like this. Continuation coverage wins when you are in the middle of treatment and need the same doctors, when you have already burned through most of your deductible for the year, or when your income is high enough that no premium tax credit is available. A marketplace plan usually wins on price otherwise, especially at lower incomes. Work through health insurance for the unemployed for the numbers on both, and COBRA alternatives for what else is out there.
One warning: electing continuation and then dropping it voluntarily mid-term does not open a marketplace special enrollment period. Running out the full term does. Decide before you elect, not after.
How to Elect It
1. Find out who administers it. Under mini-COBRA the obligation typically sits with the insurance carrier rather than the employer, though carriers can push notice and premium collection onto the small employer. If nobody has contacted you within a few weeks, call the carrier directly using the number on your old member ID card. Texas requires your employer to tell you about continuation within 30 days of the date your job ended.
2. Elect in writing, inside the window. Massachusetts and New York both give you 60 days, running from the later of the date coverage terminated or the date the notice was sent. Texas requires written notice by the 60th day. Pennsylvania is much tighter at 30 days. Missing it forfeits the right, so treat the deadline as the real one even if you are still deciding.
3. Pay the first premium on time. Massachusetts sets the first payment at 45 days after election, and the Texas rule uses the same 45-day deadline. After that, monthly, with a 30-day grace period in both states. Nonpayment is the most common way this coverage ends early.
4. Price the marketplace in parallel. The 60-day special enrollment window runs at the same time as your election window, so you can compare an actual subsidized quote against an actual continuation quote before you commit.
5. Know how it ends. Coverage terminates when the maximum period runs out, when you get other coverage, when you become entitled to Medicare, when the employer stops offering a plan, or when you stop paying.
The Bottom Line
If your old employer had fewer than 20 employees, federal COBRA probably does not apply to you, and whether you can keep your plan at all depends entirely on which state you live in. The range is real: 9 months at 105% of group rate in Pennsylvania, 36 months at 110% in California. Get the actual terms from your state insurance department, and price a subsidized marketplace plan against them before you elect, because continuation coverage carries no subsidy and often loses on cost.
If the numbers do not work in either direction, the fallback is paying cash well rather than avoiding care. Hospital charity care writes off bills for people under an income line, free and sliding-scale clinics price primary care against what you earn, prescription assistance programs cover brand drugs, and medical bill payment plans handle what is already owed. Uninsured start here is the place to begin.