Keep Your Health Coverage (COBRA)

Federal COBRA and Cal-COBRA

The Department of Managed Health Care does not administer Federal COBRA or Cal-COBRA benefits.

What is Federal COBRA?

  • Federal COBRA is a federal law that lets you keep your group health plan when your job ends or your hours are cut.
  • Federal COBRA requires continuation coverage be offered to covered employees, their spouses, former spouses, and dependent children.
  • Federal COBRA applies to employers and group health plans that cover 20 or more employees.

What is Cal-COBRA?

  • Cal-COBRA is a California Law that lets you keep your group health plan when your job ends or your hours are cut. It may also be available to people who have exhausted their Federal COBRA. 
  • Cal-COBRA applies to employers and group health plans that cover from 2 to 19 employees.
Small Employer (2 to 19 employees) Large Employer (20 or more employees)
Cal-COBRA — up to 36 months Federal COBRA — 18 or 36 months
(depends on the qualifying event)

Cal-COBRA — If Federal COBRA was 18 months, 18 more months of Cal-COBRA is available

Meet the Deadlines

  • You should get a notice in the mail about your COBRA and Cal-COBRA rights.
  • You have 60 days after being notified to sign up.
  • If you are eligible for Federal COBRA and did not get a notice, contact your employer.
  • If you are eligible for Cal-COBRA and did not get a notice, contact your health plan.
  • If you miss the deadline, you may lose the chance to sign up for Federal COBRA or Cal-COBRA.
  • Call the Help Center if you have any questions.

Questions and Answers

 

What are my benefits under Federal COBRA and Cal-COBRA?

  • You have the same benefits as other employees in the same health plan.
  • If other employees have open enrollment periods, when they can change from one plan to another, you can too.
  • If the employer changes the employees from one health plan to another, you change plans too.
  • You have no restrictions because of pre-existing conditions.
  • If the group benefit includes specialized plans, such as dental or vision plans, they must be offered to you too under Federal COBRA; however, if you change from Federal COBRA to Cal-COBRA, these specialized plans do not have to be offered to you.

 

What are the qualifying events for eligibility for Federal COBRA and Cal-COBRA?

Qualifying events are events that cause an individual to lose his or her group health coverage, most commonly because:

  • The employee is no longer employed for any reason other than gross misconduct.
  • The employee’s hours are cut.

 

What qualifying events are for the employee’s spouse and/or dependent/s under Federal COBRA or Cal-COBRA?

Qualifying events for a spouse or dependent means that you lose your health plan because:

  • The employee is no longer employed for any reason other than gross misconduct.
  • The employee’s hours are cut.
  • Covered employee becomes entitled to Medicare.
  • You are no longer a dependent of the employee.
  • Divorce or legal separation of the spouse from the covered employee.
  • The employee dies.

 

  • Why would an employee not qualify to enroll in Federal COBRA?
  • The employee does not enroll within 60 days of receiving the notice of eligibility from employer.
  • The employee is covered by another health plan.
  • If the employee has Federal COBRA and becomes eligible for Medicare; however, if an employee has Medicare eligibility prior to his or her Federal COBRA start date, the employee can remain on Federal COBRA.
  • The employee is fired for gross misconduct.
  • If the company closes.
  • If premiums are not paid on time.
  • If the company stops offering coverage to current employees.

 

Can I get Cal-COBRA if I had Federal COBRA?

  • When Federal COBRA ends, eligible employees can buy 18 months additional health coverage under Cal-COBRA.
  • All qualified beneficiaries are generally eligible for continuation coverage for 36 months after the date the qualified beneficiary’s benefits would otherwise have terminated.

 

Why would an employee not qualify to enroll in Cal-COBRA?

  • The employee is enrolled in or eligible for Medicare.
  • The employee does not enroll within 60 days of receiving the notice of eligibility from the employer.
  • The employee is covered by another health plan.
  •  The employee is fired for gross misconduct.
  • If the company closes.
  • If the company stops offering coverage to current employees.
  • If the employee is covered by a self-funded plan.
  • If the employee is covered by an out-of-state plan.
  • If the employee moves from the Health Plan service area.

 

What do I do once I receive my notice for Federal COBRA or Cal-COBRA?

  • Once you receive the notice, you have 60 days to send in your completed enrollment form.
  • After you send in your enrollment form, you have 45 days to pay your first premium.
  • Make sure you do the following:
    • Send in the enrollment form before the deadline,
    • Send it to the right place,
    • Send in the right premium amount, and
    • Pay your first premium within 45 days after you send your enrollment form.

 

What can I do when my Federal COBRA or Cal-COBRA options have been exhausted?

  • You may be eligible to apply for individual coverage through Covered California, the State’s Health Benefit Exchange. You can reach Covered California at (800) 300-1506 or online at www.coveredca.com.
  • You can apply for individual coverage directly through some health plans off the exchange.
  • You can also contact your local Health Consumer Alliance Partner for free assistance in finding a plan and applying for coverage, including Medi-Cal and other government programs. The HCA can be reached at (888)-804-3536.

Questions? Call the Help Center at (888)-466-2219.

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