Understanding COBRA in California

By Mike Radvak Employee Rights COBRA, qualifications, restrictions

Smiling female doctor with coworkers in the background

Consolidated Omnibus Budget Reconciliation Act (COBRA) is a federal law that concerns group health plans and employers that cover 20 or more employees. Its main objective is to preserve your group health plan in case your job ends or your hours are reduced.

Frequently Asked Questions (FAQs) About COBRA

Who is Eligible for COBRA?

Coverage is applicable for employees that are under an employer’s health care plan a day prior to a qualifying event. The employer in this case usually has 20 or more employees.

What is a Qualifying Event?

A qualifying event simply means loss of your health plan as a result of:

End of your job.
A cut in employee’s hours.
Divorce or legal separation from the employee.
You cease to be a dependent of an employee.
Death of an employee.
Eligibility of employee for Medicare.

How Do I Sign Up for COBRA?

First, you should receive a notice in the mail regarding your rights. After notification, you have a period of 60 days to sign up for COBRA. In case you fail to receive a notice in the mail, contact your health plan or last employer immediately. Afterwards, fill the forms required. If you are having problems accessing the forms, call the Help Center. Remember to stick to the deadline given to sign up for COBRA. Otherwise, you will lose the chance to do so. Besides, ensure you do the following:

Send the enrollment form before the stipulated deadline.
Send the enrollment form to the right place.
Pay the correct premium amount.
Pay the first premium within a period of 45 days after sending the enrollment form.

What is Cal-COBRA?

Cal-COBRA stands for California Continuation Benefits Replacement Act. It is applicable where employers and group health plans cover 2 to 19 employees. It allows a person to keep their plan for a maximum period of 36 months.
Cal-COBRA also applies to people who use up their COBRA. After 18 months of your COBRA are over, you can keep your health plan for 18 months under Cal-COBRA.

What Benefits Do I Have Under COBRA and Cal-COBRA

You are entitled to benefits similar to other employees covered by the same health plan.
If open enrollment periods apply to other employees with respect to changing from one plan to another, you can also do so.
In case employees are changed from one health plan to another by the employer, you change plans as well.

When Do COBRA and Cal-Cobra End?

Cobra will end if:

You use the 36 months. It can either be 36 months under Cal-COBRA entirely or 18 months under COBRA and 18 months under Cal-COBRA.
You fail to pay premiums on time.
The employer ceases to offer any health plan.
You become eligible or enroll in Medicare.
You decide to enroll for a different health plan.

Photo Credit: Shutterstock/S_L

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