Cal-COBRA California Mini-COBRA Continuation Coverage State-by-State Listings - The David Fluker Health Insurance Agency - Gilroy, California

Federal COBRA provides the option for continuation of group health coverage upon termination of active employment. Federal COBRA applies to any group with 20 or more employees for at least one half of the previous calendar year.

For those employers in California who fall below the federal employee population level, Cal-COBRA is available for continuation on the state level for groups with 2-19 employees.

What is Cal-COBRA?

Cal-COBRA is California's state mini-COBRA program. It applies to groups between 2-19 employees and provides an option for continuation just like federal COBRA.

Is Cal-COBRA private insurance that I have to buy?

No. You canot buy a private policy under Cal-COBRA. Like federal COBRA, Cal-COBRA is a continuation option that allows a beneficiary to stay on the employer's group health plan and pay the premium.

How long is Cal-COBRA?

Cal-COBRA is 36 months of continuation.

How much do I have to pay on Cal-COBRA?

Cal-COBRA premiums are calculated at 110% of the standard cost, which is higher than federal COBRA at 102%. If you are on Cal-COBRA, you would be required to pay your entire cost (no more employer contribution) plus 10% administrative cost.

Do I go through a COBRA administrator like federal COBRA?

No. Cal-COBRA is done directly with the health insurance carrier. You will work and pay your premiums directly to the carrier. There is no third party administration for Cal-COBRA.

If I am elect Cal-COBRA, can I get the 65% subsidy?

Yes. Part of the recent ARRA legislation requires state mini-COBRA programs to provide this subsidy for 9 months, just like federal COBRA. However, in the case of Cal-COBRA, the subsidy will be paid by the health insurance company, not the employer. Only the health insurance carrier can take the tax credit for that premium subsidy.

Why 36 months and not just 18 months like federal COBRA?

AB 1401 provided for an extension and expansion of Cal-COBRA coverage in California. Essentially, all qualifying plans allow for a full 36-month option, regardless of the qualifying event. Federal COBRA does allow for 36 months, however it must be because of certain qualifying events (divorce, death, loss of dependent status). California under AB 1401 did away with that on the Cal-COBRA and provided a standard 36 months of covearge

I was told after my 18 months of COBRA, I can get another 18 months under Cal-COBRA?

Yes, and no. AB 1401 in part provides for the extension of continuation under Cal-COBRA for an extra 18 months (to total 36 months) upon exhaustion of federal COBRA. This applies to companies of any size above 20 employees. However, there are some restrictions with regard to the extension that may or may not have and effect on a person's ability to elect the extension.

*Self-Insured/Self-Funded Group Plans are exempt
*Non-domiciled Group plans are exempt
*National PPO plans (non domiciled) are exempt (Aetna, Cigna, UHC)

So, if you are covered under a fully-insured California domiciled health plan, you will likely be eligible for the extension. If you are covered under a self-funded plan or a carrier domiciled in another state, you likely will not be eligible for the extension.

Can employees in other states get the Cal-COBRA extension?

Yes. Employees working for a California domiciled employer who provides a fully-insured California health plan can be eligible for the Cal-COBRA extension, even if they work in another state.