Art Gallagher Consulting Guide
COBRA Continuation Coverage?
Who Is Entitled
COBRA Rights and Responsibilities:
Notice and Election Procedures
Summary of Qualifying Events,
Paying for it
No Pre X Clause!
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
issued outside of California
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,
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 deadline. Emails dated 1.21.2015 2:07 PM
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.
http://www.cvtrust.org/ 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!!! healthreformquotes.com healthreformquotes.com Page 14 of Covered CA Contract with Insurance Companies steveshorr.com/
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 healthreformquotes.com Limited exceptions for plans that don’t have Essential Benefits – Grand Fathering – If you like your plan, you can keep it.
Individual Quotes & Enrollment outside of Covered CA are available at quotit.net If you need subsidies you can authorize us to help you with Covered CA by jumping these hoops. 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 leginfo.legislature.ca.gov 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.
Are short term plans available?
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.
Since COBRA has been made pretty much obsolete under Health Care Reform... not all the links work... Try scrolling the entire page or just Email us.
2. Where can I get more details on MY specific plan and options?
KQED story about a reporter taking five weeks to get coverage with Covered CA. Part of the problem was answering the question about if you have COBRA coverage. We can help you with this, no extra charge. First, get a instant quote and we will contact you.
3. What happens if your Employer changes coverage from one Insurance Company to another?
4. What if my COBRA gets cancelled?
5. What if I'm separated and my spouse cancels my coverage, is that a Qualifying event?
6. Where can I get more information on Cal COBRA?
Blue Cross Small Group Plan SAMPLE EOC
Kaiser COBRA Specialist # 866-429-0142
7. How much notice must one receive, before COBRA rates can go up?
8. Do you have an FAQ section for Cal COBRA? What is Gross Misconduct?
9. What notices must the Employer give the Employee?