The Consolidated Omnibus Budget Reconciliation Act (COBRA) of 1985 (enacted July 1, 1986), requires that employers with 20 or more employees and maintain group health plans (includes medical, dental, and vision coverage) offer continuation of benefit coverage for a specific period of time to covered employees, spouses, *domestic partners (*State of California Legislation, not federal law), and dependent children who lose group coverage due to a "qualifying event".
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During open enrollment, eligible COBRA enrollees may:
Enroll, cancel, or change your health, dental, and vision plans.
Add or delete dependents.
If you don't want to make any changes to your coverage, you don't need to do anything. Open enrollment forms must be received no later than October 9, 2015. All open enrollment changes are effective January 1, 2016.
Group coverage can be continued under COBRA for 18 months if you lose coverage based on one of the following "qualifying events":
Voluntary or involuntary termination of employment, other than for gross misconduct;
Reduction of hours; reduction of hours includes:
Full-time to part-time
Leave of absence (if the leave results in a loss of coverage)
Military call-up (24 months of coverage)
Permanent Intermittent Employee (who loses coverage based on a non-qualifying control period)
You may extend your 18 months of continuation coverage for an additional 11 months of coverage, to a maximum of 29 months, for all qualified beneficiaries if the Social Security Administration determines a qualified beneficiary was disabled according to Title II or XVI of the Social Security Act at the time of the qualifying event or any time during the first 60 days of continuation coverage. This extended period allows disabled persons continued coverage for the period of time that it normally takes to become eligible for Medicare. The state calculates your premiums for coverage beyond the initial 18 months at 150% of the state's group coverage premium rate. You continue paying this premium directly to the plan or its designee each month.
It is the qualified beneficiary's responsibility to obtain this disability determination from the Social Security Administration and provide a copy of the determination to the appropriate plan within 60 days after the date of determination and before the original 18-month COBRA eligibility period expires. It is also the qualified beneficiaries responsibility to notify the plan within 30 days if a final determination is made that they are no longer disabled.
Under California law AB 254, the provisions of SB 761 were repealed for those individuals who meet the eligibility requirements of SB 761 after January 1, 2005. What this means is that if an employee experiences a qualifying event (i.e., termination of employment) on or after January 1, 2005, then the provisions of SB 761 are not available at the end of the 18-month COBRA continuation coverage.
Under this California Law, employer-sponsored medical plans must allow an extension to COBRA coverage for an enrollee who has exhausted their initial 18 month continuation coverage period for up to 36 months from the date that coverage began. This provision only applies to continuation of medical insurance COBRA coverage. In no event will continuation coverage last beyond three years (36 months) from the original date of loss of coverage. Your personnel office calculates the premium for extended coverage for former employees beyond the initial 18 months at 110% of the state's group coverage premium rate. You continue paying this premium directly to the plan or its designee each month.
If during the 18 months of continuation coverage, a second event takes place (divorce, termination of domestic partnership, legal separation, death, or a dependent child ceases to be a dependent), you may extend the original 18 months of continuation coverage to 36 months from the original date of loss of coverage for eligible dependent qualified beneficiaries. If a second event occurs, it is the qualified beneficiary's responsibility to notify the plan in writing within 60 days of the second event and within the original 18-month COBRA timeline.
In no event will continuation coverage last beyond three years (36 months) from the original date of loss of coverage.
Group coverage can be continued under COBRA for 36 months if you lose coverage based one of the following "qualifying events":
Death of employee;
Divorce, legal separation, or *termination of domestic partnership; or
Child ceases to be a dependent (i.e., child turns 26)
* (State of California legislation)
COBRA administrators can find Word versions of COBRA forms on HR Net.