Employee's guide to COBRA - Department of Labor
Employee’s guide to COBRA – Department of Labor

California Cal-Cobra (Insurance Code §10128.50   Our site with annotations) allows one, be they the employee, spouse or child to  keep their prior Employer Group Medical Insurance Coverage when you lose your job or have another qualifying event.  Some examples are:

Cal COBRA coverage extends for 18 months after Federal COBRA which covers employers of 20 or more, expires, even if you were an owner or partner of the company.  If you worked for a Small Employer, under 20 employees, Cal COBRA provides the entire 36 months of coverage.  When Cal COBRA ends, we can help you obtain, buy Coverage, (HIPAA is no longer available) coverage for your new business or an Individual & Family Plan. (SB 719, California Continuation Benefits Replacement Act §10128.50 et seq. ,  §1366.2,  AB 1401 )    401 K Rollover?

On the other hand, with Guaranteed Issue Health Care Reform, we don’t think COBRA or Cal COBRA carries the tremendous value that it did in the past.   Covered CA explanation of Cobra vs ObamaCare.

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Click here for instructions  to appoint us as your agent for FREE year around support.   There is no more pre-exisiting condition clause and even though it’s not Open Enrollment, when you lose group coverage is a Qualifying Event that gives you 60 days to enroll in an Individual Plan.

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Consumer Links

Department of Managed Health Care on COBRA & Cal COBRA

Employee Guide to Cal Cobra (20 Pages)

Disability Benefits 101 FAQ’s Cal COBRA

Pit Falls of Cal COBRA – DI 101

DOL (Dept. of Labor) More Info – Job Loss

DMHC Laws relating to Health Care Plans in CA

 Other pages in this section

Evidence of Coverage

Insurance Company WebPages, then look for Administration Page to find
EmployER Administrative Manuals

Senior COBRA

Technical & Research Links

Actual Text of Cal COBRA Law 

California Continuation Benefits Replacement Act,

10128.51.  (a) “Continuation coverage” means (b) “Group benefit plan” has the same meaning (d) “Qualifying event(e) “Employer” means (f) “Core coverage” means (g) “Noncore coverage” 10128.52. AB 112  10128.53. (a) Every disability insurer (c) Every disability insurer

10128.54.  (a) 10128.55.  (a)10128.56. 10128.57.  (a) (7) The employer, or any successor employer or purchaser of the employer, ceases to provide 10128.59.  (a) (d) This section shall not apply toKnox Keene Heath Care Act

 

Changing to Different COBRA plans?

When you have COBRA or Cal COBRA, you have the same rights as other employees.

You may change plans at Plan Anniversary – Open Enrollment, otherwise everything is the same as when you were an employee, other than you are paying all the premium and a 2% surcharge for the extraexpense of an individual vs group employER invoice.

 

6 comments on “California Cal-COBRA

  1. I know it will be expensive whichever [ACA Obamacare] plan I choose, but I have drug coverage with my Cobra plan for $535/month.

    I’m hoping to find something more reasonable if possible.

    Any suggestions?

      • Basically, I have great coverage from Wells Fargo, but was hoping to pay less than $535/month for coverage.

        There doesn’t appear to be an option that will provide the level of coverage I have for much less than I’d be paying via COBRA.

        I can’t see researching doctors, meds, etc. to get comparable coverage for perhaps a few dollars less.

        Am I missing something, Steve?

        I guess I thought bidding this would give me some more affordable options, but I’m not seeing anything less than $500 (right?).

        • Right, in your case at age 59 and Wells Fargo must be funding your COBRA program, you’ve got a great plan. President Obama’s promise of saving $2,500/family didn’t happen.

          Check with us in 18 or 36 months depending on if Wells Fargo is subject to Cal COBRA or Federal COBRA. Here’s Wells Fargo Websites on their Health Coverage.

          https://teamworks.wellsfargo.com/index.html

          https://teamworks.wellsfargo.com/handbook/HB_Online.pdf

          https://cobra.ehr.com.

          https://cobra.ehr.com/ESS/FAQ/FAQsESS.pdf

          Do the Marketplace health plans cost less than my COBRA coverage?

          Since the COBRA premium is the full cost [Then you are getting a great deal – Maybe Wells Fargo doesn’t age rate and the rate for a 20 year old is the same as an older person?] of your former employer group health plan plus a 2% administrative fee, it is possible that one or more of the Marketplace plans will be less expensive than COBRA coverage.

          Our Quote Engine includes Covered CA. Rates are the same in and out of Covered CA. This year though, Silver is less outside of Covered CA. If you are low income and get subsidies, that might be a wash.

  2. I will be exhausting my COBRA coverage within 6 months & am counting on CAL-COBRA for additional coverage. Immediately after retirement I moved out of California. Will this affect CAL-COBRA coverage? I have been paying my premiums on time.

    • Here’s a sample Group policy from Blue Cross, see page 128 for Cal COBRA rules. See # 8 on page 130, once you move out of the service area, you wouldn’t be able to continue cobra. On page 151 Service Area is defined as The geographical area where you can get Covered Services from an In-Network Provider.

      Here’s confirmation from the DMHC.CA.Gov website:

      When do Federal COBRA and Cal-COBRA end?

      They end when:

      You move outside the health plan’s service area.

      The ACA – Obamacare is all guaranteed issue. Check with a local agent.

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