COBRA in Illinois lets you keep your employer’s group health plan after you lose coverage, usually for up to 18 months under federal law or 12 months under the state’s Mini-COBRA law for smaller employers. You pay the full premium yourself plus a 2% administrative fee, and the same doctors, prescriptions, and benefits stay in place. Two frameworks run in parallel: federal COBRA covers group plans at employers with 20 or more workers, and Illinois Mini-COBRA (215 ILCS 5/367.2) extends similar rights to employees of businesses with 2 to 19 workers.1Illinois General Assembly. Illinois Code 215 ILCS 5/367.2 – Continuation Privilege
Who Is Eligible and What Triggers Coverage
Federal COBRA applies if your former employer normally employed 20 or more workers on a typical business day in the prior calendar year.2Office of the Law Revision Counsel. 29 U.S. Code 1161 – Plans Must Provide Continuation Coverage If the employer is smaller, Illinois Mini-COBRA steps in and requires the insurer to offer you the same group coverage you had as an active employee. A separate state provision, 215 ILCS 5/367.2-5, gives dependent children their own continuation rights of up to two years when the covered employee dies or when the child reaches the plan’s age limit.3Illinois General Assembly. Illinois Code 215 ILCS 5/367.2-5 – Dependent Child Continuation Privilege
You, your spouse, and any children who were covered the day before the qualifying event can each elect continuation. The qualifying events for the employee are job loss (voluntary or involuntary) and a reduction in hours below the plan’s eligibility threshold. For spouses and children, the triggering events are the employee’s death, divorce or legal separation, the employee becoming entitled to Medicare, or a child aging out of dependent status, which under the Affordable Care Act is typically at age 26.4U.S. Department of Labor. FAQs on COBRA Continuation Health Coverage for Workers
One exclusion applies to both federal COBRA and Mini-COBRA: an employee fired for gross misconduct is not entitled to continuation coverage. Federal law does not define the term, but ordinary reasons like poor performance, excessive absences, or a general layoff do not count.5U.S. Department of Labor. Health Benefits Advisor Glossary – Gross Misconduct The exception is generally reserved for serious conduct such as theft, violence, or fraud.
How Enrollment and Payment Work
After a qualifying event, your employer has 30 days under federal law to notify the plan administrator of events like termination, reduced hours, death, or Medicare entitlement. The plan administrator then has 14 days to send you an election notice.6Office of the Law Revision Counsel. 29 U.S. Code 1166 – Notice Requirements For divorce or a child losing dependent status, you or a family member must notify the plan administrator, typically within 60 days. Under Illinois Mini-COBRA, the employer must provide written notice of continuation rights within 10 days of the qualifying event. If you haven’t received a notice, follow up with HR.
Once the election notice arrives (or your coverage ends, whichever is later), you have 60 days to decide.4U.S. Department of Labor. FAQs on COBRA Continuation Health Coverage for Workers Payment doesn’t have to accompany the election form; the paperwork alone meets the deadline. Miss the 60 days and you permanently lose the right to COBRA for that event.
Coverage is retroactive to the day your prior plan ended, so there is no gap even if you take the full election window to decide.7U.S. Department of Labor. COBRA Continuation Coverage Any medical care you receive during the decision period gets paid for once you elect and pay. Your first premium is due within 45 days of the date you elect, and it often covers every month back to the date your group coverage ended, making it a sizable lump sum.8Centers for Medicare & Medicaid Services. COBRA Continuation Coverage Questions and Answers After that, the plan must accept monthly payments and allow a 30-day grace period on each one.4U.S. Department of Labor. FAQs on COBRA Continuation Health Coverage for Workers Missing any payment deadline, including the grace period, permanently ends your COBRA rights.
How Long You Can Stay on COBRA
Under federal COBRA, the maximum period depends on the event:9Office of the Law Revision Counsel. 29 USC 1162 – Continuation Coverage
- 18 months for termination of employment or reduction in hours.
- 36 months for the covered employee’s death, divorce or legal separation, Medicare entitlement, or a child losing dependent status.
If a second qualifying event hits during an 18-month period (for example, the employee dies, divorces, or becomes Medicare-eligible), dependents can extend to 36 months from the original qualifying event date. You must notify the plan administrator of the second event to trigger the extension.
A disability extension is available if you or a covered family member is determined to be disabled by the Social Security Administration either before COBRA begins or within the first 60 days of coverage. In that case, the 18-month period extends to 29 months.10U.S. Department of Labor. Health Benefits Advisor – Disability Extension You have to notify the plan administrator of the SSA determination within the first 18 months and within 60 days of receiving it. The premium during the 11-month extension can rise to 150% of the plan’s cost.
Illinois Mini-COBRA runs for a shorter 12 months for most qualifying events. The separate dependent child continuation under 215 ILCS 5/367.2-5 lasts up to two years.
What COBRA Costs
As an active employee, your employer paid a large share of the premium. On COBRA, you pay the whole thing: your old share, your employer’s share, and a 2% administrative fee, for a total of 102% of the plan’s cost.11U.S. Department of Labor Employee Benefits Security Administration. FAQs on COBRA Continuation Health Coverage for Employers and Advisers Under the disability extension, months 19 through 29 can be billed at up to 150%.
For scale, the average total annual premium for employer-sponsored coverage in 2025 was roughly $9,325 for single coverage and about $26,993 for family coverage, according to the Kaiser Family Foundation’s annual survey. At 102%, that’s about $793 a month for an individual plan or about $2,294 a month for family coverage. Your actual bill depends entirely on your former employer’s plan, and the election notice will state the exact premium.
When COBRA Ends Before the Maximum Period
Continuation coverage can end early for several reasons:4U.S. Department of Labor. FAQs on COBRA Continuation Health Coverage for Workers
- You miss a premium payment and the grace period runs out.
- You enroll in another employer’s group health plan after electing COBRA.
- You become entitled to Medicare after your COBRA election.
- Your former employer stops offering any group health plan.
- You engage in conduct, such as fraud, that would justify terminating any similarly situated participant.
Starting a new job with health insurance is the most common cause. Confirm the effective date of the new coverage before dropping COBRA so you don’t create a gap.
If You Are Near 65 or Already on Medicare
COBRA does not pause the Medicare clock. You have an 8-month Special Enrollment Period to sign up for Medicare Part B after your employment ends or your employer coverage stops, and the clock starts then, not when COBRA runs out.12Medicare.gov. COBRA Coverage Missing that window means a lifetime Part B late enrollment penalty and a gap in coverage until the next general enrollment period. If you already have Medicare, it pays first and COBRA pays second for most people age 65 or older or qualifying through a disability.13Centers for Medicare & Medicaid Services. Medicare Secondary Payer
Marketplace Coverage Through Get Covered Illinois
COBRA is not the only option, and often it is not the cheapest. Losing employer-sponsored coverage opens a 60-day Special Enrollment Period on the Health Insurance Marketplace, which in Illinois runs through Get Covered Illinois.14HealthCare.gov. Getting Health Coverage Outside Open Enrollment Marketplace plans often cost less because you may qualify for premium tax credits based on household income. You can decline COBRA and still qualify for those subsidies.15Internal Revenue Service. Questions and Answers on the Premium Tax Credit
COBRA still wins in specific situations. If you are mid-treatment with doctors who are in the group plan’s network but not in available Marketplace networks, staying on COBRA keeps that care continuous. If you have already met your deductible for the year, switching plans resets it. Compare actual premiums, networks, and out-of-pocket costs before deciding.
If Your Employer or Insurer Does Not Comply
If your employer or insurer fails to offer continuation coverage, sends the notice late, or improperly denies your election, you can file a complaint with the Illinois Department of Insurance using its Consumer Health Care Complaint Form, available online and by mail.16Illinois Department of Insurance. How to File a Complaint The department can also be reached at (312) 814-2420 in Chicago or (217) 782-4515 in Springfield. For federal COBRA problems, the U.S. Department of Labor’s Employee Benefits Security Administration oversees employer compliance under ERISA.7U.S. Department of Labor. COBRA Continuation Coverage Employees can also bring a civil suit under ERISA for a failure to provide required COBRA notices, and courts can award statutory penalties, legal fees, and an order requiring the coverage.