California COBRA Insurance
In addition to the federal COBRA insurance coverage, the state of California also offers an extended COBRA insurance plan for employees at companies with between 2-19 employees. This means that even if you do not meet the requirements for federal COBRA insurance, you may still be eligible for COBRA insurance coverage in California. This law is Cal-COBRA.
Eligibility: In order to be eligible for Cal-COBRA insurance coverage, you must have been covered by the employer group health insurance plan when you lost your employment and must not qualify for federal COBRA insurance. As with federal COBRA laws, your beneficiaries are also eligible for COBRA insurance in California. You are not eligible for Cal-COBRA insurance if you are eligible for Medicare, MediCal, or if you qualify for another group health insurance plan.
Signing Up: Your employer by law is required to notify you that you are eligible for Cal-COBRA insurance within 30 days of the qualifying event that causes you to lose coverage. You will then have 60 days to elect Cal-COBRA coverage. Cal-COBRA, unlike federal COBRA insurance, is handled individually by the health insurance provider, therefore each insurer may have slightly different forms and specific sign up requirements. You can always contact the health insurance provider for support in completing these forms.
Length of Coverage: Cal-COBRA insurance can last between 18-36 months depending on your exact circumstances and qualifying event.
Termination: Cal-COBRA insurance can be terminated for a variety of reasons. The most common reasons for termination of Cal-COBRA insurance coverage is failure to pay premiums, termination of the group health insurance plan by the employer, or eligibility for another group insurance plan.
Cost: Cal-COBRA insurance costs are based on the insurance premium cost under the group insurance plan you participated in as an employee. Depending on your employer, they may have paid the entire premium or part of the premium. Under Cal-COBRA insurance benefits, you will be responsible for paying the 110% of the premium. Although this may seem high, it is still significantly less than you would pay for similar heath insurance coverage if you bought individual health insurance. It is also important to know that when you sign up for Cal-COBRA insurance, you will be responsible for any monthly premiums retroactively since the date of employment loss since the coverage covers that entire period.
For help signing up for Cal-COBRA insurance, you may consider contacting the following state agencies.
California Department of Insurance (CDI)
State agency with information on COBRA
1-800-927-4357 (many languages)
1-800-482-4833 (TTY)
www.insurance.ca.gov
U.S. Department of Labor COBRA
Information on the Federal COBRA program to help you keep group health insurance if you lose your job or your hours are cut.
1-866-444-3272 (Spanish, Chinese)
1-877-889-5627 (TTY)
www.dol.gov/dol/topic/health-plans/cobra.htm
www.dol.gov/ebsa
Let us find you the right insurance plan. We are able to find the best rates from Blue Cross and Blue Shield, Humana, Aetna and other insurance providers.
Frequently Asked Questions
What is the difference between federal COBRA insurance and Cal-COBRA insurance?
The main difference between federal COBRA insurance and Cal-COBRA insurance is who is eligible. Under the federal law, employees are only eligible for COBRA insurance if they work at a company with 20 or more employees (or their part time equivalents). However, if you work at a smaller company with between 2-19 employees than you can enroll in Cal-COBRA, a state extension of the federal COBRA medical insurance law. The second key difference is that Cal-COBRA lasts for 36 months, as opposed to the 18 months most typically provided with federal COBRA. Once you exhaust your federal COBRA eligibility, in most cases you can sign up for Cal-COBRA.
Will my benefits change if I switch from federal COBRA insurance to Cal-COBRA insurance?
If your federal COBRA insurance runs out and your switch to Cal-COBRA insurance to extend your benefits for an additional 18 months, your general health insurance plan will stay the same. This means the same doctors will be covered, you will have the same co-payments and deductibles, your prescription plan and coverage area will stay the same, etc. However, any dental or vision insurance coverage that you may have received under federal COBRA insurance can be cancelled and no longer offered under Cal-COBRA.
How do I sign up for or elect to use Federal COBRA or Cal-COBRA?
Since federal COBRA insurance and Cal-COBRA insurance are both laws that allow someone to continue to receive their health insurance, rather than medical insurances themselves, signing up or electing federal COBRA insurance or Cal-COBRA insurance will happen with your former employer. The company is required to provide you with a COBRA insurance election form, or Cal-COBRA insurance election form, and you will have 60 days to decide if you want to enroll. If you do not receive this form from your employer quickly, you should seek it out from the Human Resources department. Then you simply need to complete the election form and mail it with the premium.
When do Federal COBRA and Cal-COBRA end?
Under most circumstances, federal COBRA insurance and Cal-COBRA insurance end at the end of the coverage period, either 18 months under federal COBRA medical insurance, or 36 months with Cal-COBRA insurance. However, there are certain circumstances that can trigger loss of either federal COBRA medical insurance or Cal-COBRA health insurance. The first is if you fail to pay a premium on time, your plan can be cancelled. Furthermore, if you become eligible for or enroll in Medicare, you can no longer receive benefits under COBRA insurance at the state or federal level. Additionally, if you sign up for another health insurance plan, move outside of the coverage area, or your company stops offering health insurance, you will not be able to continue to receive health insurance under the federal COBRA insurance law or Cal-COBRA insurance law.
Who is eligible to enroll in Federal COBRA or Cal-COBRA?
The qualifying conditions for receiving federal COBRA insurance or Cal-COBRA are very similar, the key difference being the number of employees who work at the company and sometimes the length of coverage. Generally, you can qualify for COBRA insurance from the federal government if you work at a company with 20 or more employees (or their part time equivalent) and have a qualifying event. A qualifying event refers to reason that you could lose your group health insurance coverage. In most cases, you will qualify for federal COBRA insurance if you have lost, quit, resigned, or retired from your job and were not fired for gross misconduct. Under the COBRA insurance laws, anyone previously covered by your group health insurance will be eligible to continue to keep group health insurance benefits under the COBRA insurance law. In the law this is known as a qualified beneficiary. Federal COBRA insurance typically lasts for 18 months.
If you do not qualify for federal COBRA insurance because you work at a company with fewer than 20 employees, you may be eligible for Cal-COBRA insurance, which is a California state COBRA insurance program. To ensure that residents in California who work at companies with between 2-19 full time employees, the state passed a similar law to COBRA that extends to workers at smaller companies and allows them to continue to receive their group health insurance. Under the Cal-COBRA law, you can qualify to continue your group health insurance for up to 36 months given you meet the requirements. The basic requirements for Cal-COBRA are that you have lost, quit, resigned, or retired from your job and were not fired for gross misconduct, known as the qualifying event. From there, anyone who was previously covered under your policy, known as the qualifying beneficiaries, will likely be covered under Cal-COBRA insurance and have the option to continue to receive health insurance benefits.
Who cannot enroll in Federal COBRA or Cal-COBRA?
Most people will qualify for federal COBRA insurance or Cal-COBRA insurance as long as they were not fired from their job for gross misconduct. You must sign up within the 60 day enrollment window and pay premiums on time to ensure coverage.
Can I continue my insurance after Federal COBRA or Cal-COBRA ends?
Unfortunately, you will not be able to continue to receive health insurance through federal COBRA insurance or Cal-COBRA once you have exhausted both resources. Once you reach that point, you will need to seek out alternative insurance options including private insurance plans and state or government insurance plans. Learn more about these insurance plans by calling: 1-877-675-3461 or reading about alternative policies here.
What are my benefits under Federal COBRA and Cal-COBRA?
Under both federal COBRA insurance and Cal-COBRA insurance, you will keep the same benefits you had under your group health insurance plan when you were employed. This means that the same doctors, co-payments, deductibles, and entire plan will stay exactly the same. If there is open enrollment at your company it will also apply to you under federal COBRA insurance and Cal-COBRA insurance. This also means that if your employer changes their health plan at all, the same changes will apply. Additionally, if your health insurance plans offer dental or vision care, this will also be offered with federal COBRA insurance and Cal-COBRA insurance. The only difference is when you switch from federal COBRA insurance to Cal-COBRA insurance, there is a chance that dental and vision coverage may not be offered. Your Human Resources department at your former employer and/or group health insurance provider will be able to tell you if this changes.
What is Cal-COBRA?
Cal-COBRA is a state run COBRA insurance plan, set up by the state of California, to ensure that employees who work at companies with under 20 employees, and therefore do not qualify for the federal COBRA insurance policy, can still be eligible to elect to continue their group health insurance plan for up to 36 months. Similar to the federal COBRA insurance law, you must meet the state requirements and will be responsible for paying the full premium plus an administration fee.
Can I enroll in Cal-COBRA insurance after my federal COBRA insurance runs out?
If you only received federal COBRA insurance benefits for 18 months there is a strong likelihood that you will be able to continue your group health insurance coverage under Cal-COBRA insurance for an additional 18 months. In order to find out if you are able to extend your COBRA insurance benefits under Cal-COBRA you should reach out to your group health insurance company and/or former employer.
