Short answer: Texas State Continuation is a Texas law that allows individuals to temporarily continue fully insured group medical coverage after losing eligibility, either for up to 9 months or for up to 6 months after COBRA ends.
Texas State Continuation is a state continuation requirement that applies to fully insured group health insurance policies issued in Texas, regardless of employer size. It does not apply to self-funded plans.
How the rule works depends on whether the employer is subject to federal COBRA.
For employers not subject to COBRA, generally those with fewer than 20 employees, Texas State Continuation is the primary continuation option. Eligible individuals may continue coverage for up to 9 months following a qualifying loss of coverage.
For employers subject to COBRA, generally those with 20 or more employees, Texas State Continuation applies after COBRA is exhausted. If an individual uses the full 18 months of federal COBRA, Texas law allows an additional 6 months of continuation, for a total of up to 24 months of continued coverage.
To qualify, the individual must have been covered under the group medical plan for at least three consecutive months immediately before coverage ended. Texas State Continuation applies only to group medical insurance and does not extend to standalone dental, vision, or other non-medical benefits.
Sources
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Texas Department of Insurance, State Continuation of Coverage
https://www.tdi.texas.gov/pubs/consumer/cb046.html -
Texas Insurance Code §1251.251–1251.257
Content history
Originally published: June 16, 2025
Last reviewed: January 25, 2026