Employers who provide group medical insurance are required by FHICCA to give employees the opportunity to apply for continuation coverage in certain instances. This act applies to companies with fewer than 20 employees. Coverage is continued for the employee as well as a spouse and covered dependents. The act was created to help employees not protected under the federal law called the Consolidated Omnibus Budget Reconciliation Act (COBRA).
Under Florida law the employee and/or family has 63 days to inform the insurance company of the qualifying event that led to a loss of coverage. The notice to the insurance company must be in writing and include the name and social security number of the qualified beneficiary, along with information about the qualifying event. The date coverage was canceled, name and phone number of the employer, and the group health plan number must also be included. If the beneficiary has dependents, the name, social security number, address, and phone number of each dependent is required.
A qualifying event can be a loss of medical insurance due to a reduction in hours or termination of employment. Coverage is available for the spouse and dependents if the employee dies, in the event of a divorce or legal separation, or if the employee becomes eligible for Medicare. Lastly, a dependent who turns 25 years old can apply for continuation coverage. An employee released of duties because of gross misconduct cannot apply for the coverage.
Time Frame and Cost
The length of coverage depends on the individual's situation and reason for applying. Coverage can be for a minimum of 18 months and last up to 36 months. The coverage will be identical to the group medical insurance provided by the employer. The cost will be the full cost up to 150 percent of the applicable group rate.
Continuation coverage can be canceled in certain instances, such as when a former employer discontinues group health coverage for all employees or if an individual is more than 30 days late with the payment. If the covered individual becomes eligible for medical insurance through another employer group plan, coverage can be canceled. Lastly, continuation coverage will end if the insured becomes eligible for Medicare.
An employee who is laid off or has a reduction in work hours can be left with no medical insurance coverage. The Florida Health Insurance Coverage Continuation Act (FHICCA) offers continuation coverage to employees who work for a company with less than 20 employees. An employee should understand the purpose, eligibility requirements, cost, and the time period for coverage.