What You Need to Know About Health Care Rights for North Carolina Employees

Health insurance is a valuable employee benefit that provides a comforting safety net for unforeseen health problems. Here’s everything you need to know about health care rights for North Carolina employees.

North Carolina employers do not have to offer health insurance. However, eligible employees can request continuation after termination if an employer provides health care coverage.

Does North Carolina Require Employers to Offer Health Insurance?

North Carolina law does not require private employers of any size to offer health insurance plans. However, the 2010 Affordable Care Act (ACA) imposes penalties on large businesses (50 or more employees) that fail to provide a health care plan to full-time employees.

All North Carolina state agencies offer State Health Plans to full-time employees. State Health Plan coverage exceeds ACA standards.

North Carolina State Continuation Law

While North Carolina employees do not have the right to employee health care plans, they have some health care rights if their employer offers a coverage plan. One of these is the right to continuation.

North Carolina continuation rights allow employees to stay on their employer’s health care plan after termination. Employees who lose health insurance benefits because of reduced hours or other eligibility problems are also eligible for continuation.

North Carolina’s continuation rights last for up to 18 months. Eligible employees and their dependents can remain on an employer’s health care plan for up to 18 months after losing eligibility.

Related: North Carolina Employee Monitoring Laws

North Carolina Health Care Continuation Eligibility

Not all North Carolina employees are eligible for health care continuation. Employees can only claim continuation if the employer’s health policy covers them for at least three consecutive months leading up to their termination.

In addition, an individual who becomes eligible for a similar employer health care plan within 31 days of losing eligibility cannot request continuation. This exception applies to employees who find a new job immediately after losing health care eligibility. Even if an individual opts out of their new insurance plan, they are ineligible for continuation.

North Carolina Continuation Benefits

State continuation requires employers to offer continuation for hospital, surgical, or major medical benefits. However, North Carolina employers can legally discontinue dental, vision care, and prescription drug benefits after termination. As a result, North Carolina employees who apply for continuation may still want to purchase an individual plan to cover dental, eye, and prescription insurance.

Notification of North Carolina Continuation

North Carolina requires employers who offer health care to inform employees of their continuation rights. Employers must include a continuation rights notification on each statement of coverage.

While not required by North Carolina, some employers notify employees of their continuation rights during the exit process.

How to Request Health Care Continuation in North Carolina

While North Carolina guarantees continuation rights, employees must still request continuation in writing. Usually, employers will provide a continuation request form. Each employee has 60 days after losing eligibility to request continuation.

Employees who request continuation have the right to pay monthly health care premiums. As a result, employers cannot bill continuation employees quarterly, bi-annually, or annually.

North Carolina Continuation Termination

In North Carolina, continuation does not last forever. Employees who request continuation lose eligibility on the earliest of the following dates:

  • 18 months after beginning continuation
  • The date the individual stops paying premiums
  • The date the individual becomes eligible for another government or employer health care plan
  • The date the employer terminates the group policy

If an employer switches insurance plans, all employees on state continuation also switch to that plan for their remaining continuation period.

Related: 10 Subtle Forms of Sexual Harassment in the Workplace

Consolidated Omnibus Budget Reconciliation Act

The Consolidated Omnibus Budget Reconciliation Act (COBRA) is a federal law applying to employers with more than 20 employees. Like North Carolina state law, COBRA allows eligible employees to receive health care continuation for 18 months.

Unlike state continuation, federal continuation allows some employees to extend health care coverage past 18 months.

Contact Us

If you or a loved one would like to learn more about Health Care Rights for North Carolina Employees, get your free consultation with one of our Employment Attorneys in North Carolina today!