Steve talks about Cal – COBRA

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

What if my Employer was out of State or Self Insured, can I get Cal COBRA, HIPAA, Small Biz Plan or a Individual Plan?

If you worked for an non CA Employer headquartered Out of State, they do not have to offer you the additional 18 months of Cal Cobra coverage after COBRA or the original 36 months, if they are a small employer. 10128.53) and not subject to Federal COBRA.  Nor if your former employer was self insured.  If this happens you can go straight to HIPAA (in the past  AB 1180 ends HIPAA for new enrollees) or try for a preferred GUARANTEED ISSUE ObamaCare Individual plan.

The CA Insurance Code shall not apply to a policy… that covers hospital, medical, or surgical expenses and that is 

It’s possible that your Employer might be in CA, but is owned by a larger company, headquartered out of CA and thus they may not have to offer Cal COBRA.


Since everything now is Guaranteed Issue with No Pre-X under Health Care Reform, consider going on an Individual Plan,

GET FREE ObamaCare Guaranteed Issue QUOTES

Even if it’s NOT Open Enrollment, there is Special Enrollment.  Under Special Enrollment, your coverage is the first of the month after you apply, rather than the crazy 15th and miss a month deadlineEmails dated 1.21.2015 2:07 PM

 Self-Insured Plans

The 36 months of Cal COBRA coverage does not apply to self insured health care plans that are covered by the Employee Retirement Income Security Act (ERISA).disability benefits 101.orgMetropolitan Life Insurance Company v. Massachusetts, 471 U.S. 724 (1985), the U.S. Supreme Court ruled that state laws governing self-insured benefit plans are subject to ERISA preemption.  Foley & Lardner Attorney Analysis

Case Law  (Stare Decisis)

Accident policy, applied for and delivered in California where premiums were paid, was California contract, as regards question what law governed. Palmquist v. Standard Acc. Ins. Co., S.D.Cal.1933, 3 F.Supp. 356.

A resident of Missouri signed in that state an application for life insurance. The policy was executed by the insurer at its office in New York, and transmitted to Missouri, where it was delivered to the assured, and where the premiums thereon were paid.

Held, that the policy only became a completed contract on its delivery and the payment of the premium in Missouri, so that it is a Missouri contract, and governed by the laws of that state. Equitable Life Assur. Soc. v. Pettus140 U.S. 226, 11 S.Ct. 822U.S. 1891

 This may be in conflict with  the US Constitution (State’s Relations) Article 4 Section 1,  Full Faith and Credit shall be given in each State to the public Acts, Records, and judicial Proceedings of every other State. And the Congress may by general Laws prescribe the Manner in which such Acts, Records and Proceedings shall be proved, and the Effect thereof.  McCarran Ferguson Act? CA Insurance Code §41  All insurance in this State is governed by the provisions of this code.

Related Pages

     FAQs / Ask Us a Question one of the state’s largest self-funded PPO public schools’ trust

Since they are self funded the trust comes under the “self-funded or insured” exemption in the webpage above.

My guess would be that they were just being nice to you, giving you the additional 18 months of coverage.

Under Health Care Reform – Covered CA wants everyone to be covered under the new plans, so that they get everyone, not just those who need subsidies or guaranteed issue. Thousands of policies were cancelled!!!

Page 14 of Covered CA Contract with Insurance Companies

I’m still recovering as an agent, as many of my policy holders still are not getting their premium noticies correctly.

Covered CA and the Government think they know what is best for you.

Essential Benefits

Limited exceptions for plans that don’t have Essential Benefits – Grand Fathering – If you like your plan, you can keep it.  grandfathering/

New Obamacare being guaranteed issue – no medical questions asked
end-stage-renal/ (Scroll to the bottom of the page for citations)

Individual Quotes & Enrollment outside of Covered CA are available at

If you need subsidies you can authorize us to help you with Covered CA by signing and returning this form. DELEGATE%20AGENT.pdf
Otherwise, Covered CA wants to destroy the independent insurance agent

You can get coverage within 60 days of losing COBRA without having to wait for open enrollment special-enrollment-triggering-events/


Got a notice that I wont be offered Cal-Cobra after my 18 months of Federal Cobra on my Heath Insurance because of “Health Reform”.

***I’m not aware of any provision of Health Reform that changed the rules of Cal COBRA. I double checked the law on the State’s website and don’t see that it’s been repealed.

Please send a copy of the letter, either by scanning to pdf, using your smartphone and sending a jpg or fax to 310.519.1359

Last year I was told I would be given 36 months of Cobra both Feds and Ca.

***That’s my understanding of the law, if your employer is subject to cal cobra. Please read the three criteria above.

I am currently receiving better health insurance at a cheaper price than Covered Ca. can give me.

***You can double check the rates at

I was hoping to ride this Cobra Train until Medicare at 65.

I am almost 63.

4 comments on “Out of State Employer

  1. Employer payments for my Health Care Plan ended when I turned 65.

    Under a special enrollment period, we applied for coverage under my husbands government retirement plan.

    My original plan covered me, my husband and my disabled dependent daughter age 28.

    My spouses group insurance is denying my request to enroll my daughter – citing that she needed to be continuously enrolled (with them) beginning at the age of 26.

    This appears to be a discrimination under HIPPA or ERISA.

    I am wondering if I should proceed to a fair hearing.

  2. I was employed by a 200 person company for 4 years and had Anthem Prudent PPO group insurance. I went on to Cobra after leaving the job, and paid the full premiums. Six months later, the company went to a self-insured plan still offering Anthem Prudent PPO.
    1) Is there any grandfather clause or law that would allow me to get CalCobra since I was already on Cobra before the change to self insured was made?
    2) Can they simply refuse to offer CalCobra even though I was told in email it would be offered to me because I was already on Cobra before the change?

    • I’m not aware of any grandfathering provision that would make an Employer Offer Cal COBRA if the employer goes out of business, moves to a self insured plan or simply stops offering Medical Insurance. There has to be an Insurance Plan for the COBRA to “come from.”

      Under Health Care Reform, you can get an Individual Policy regardless of your health status – pre-existing conditions, at the same rates as everyone else. You may even qualify for subsidies. Get a FREE quote here.

      If you still insist you want Cal COBRA, try following the links above, but I doubt it.

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