I have been placed on early maternity leave due to complications at approx. 30wks. My employer is telling me that the only way to keep insurance is to resign and elect Cobra benefits. Although I will more than likely not go back after the birth, I do not feel I should be forced to resign. There are no FMLA benefits since the staff is under 50 employees.

Technically, if you no longer satisfy the requirements to be covered under the health care plan, then you could be offered COBRA. This is true even if you just dropped your hours or went on an unpaid leave if that is how your plan is written.

A separate issue is whether or not you resign or your employer terminates you. Neither impact COBRA any differently. You don't say how small your employer is or what they may have done for others with temporary medical conditions of a similar duration in terms of leave. From a strictly legal standpoint, you don't qualify for FMLA so you aren't guaranteed any set amount of leave and yes, your employer can terminate you if they can/will not offer a LOA.