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COBRA Frequently Asked Questions

​What is COBRA?

The Consolidated Omnibus Budget Reconciliation Act (COBRA) is a federal law. The COBRA statute requires employers to offer continuation of group coverage (e.g., medical, dental, and vision) to covered employees, spouses, *domestic partners, and eligible dependent children who lose group coverage due to a qualifying event. These individuals are known as "qualified beneficiaries". The terms and timeframes are set by the Department of Labor and Internal Revenue Service (IRS).

Federal Legislation (Public Law 99-272, Title X)

Consolidated Omnibus Budget Reconciliation Act of 1985 (effective July 1, 1986)

(*State of California Legislation)

What does the term "qualified beneficiary" mean?

The term "qualified beneficiary" means, an individual that is eligible to continue group coverage because of a qualifying event. The individual must have been covered under the plan before the qualifying event date. If the individual was not covered, he/she is not eligible for COBRA.

Exception: Newborn or Child Placed for Adoption (deemed a qualified beneficiary, although not covered at time of the qualifying event).

A National Medical Support Notice (NMSN) and Qualified Medical Child Support Order (QMCSO) judgment, decree, or order that requires that a child receive benefits under group coverage. A child enrolled in group coverage when ordered by a NMSN or QMCSO is deemed a qualified beneficiary under COBRA law, regardless of his/her status as a dependent of the covered employee.

When do I receive COBRA information?

Once you and your dependents (if any) are covered under "group coverage" your personnel office is required to provide you and your eligible dependents with an Initial General COBRA Notice of your rights under COBRA within 90 days after coverage begins. This notice includes information on COBRA Qualifying Events and your responsibility to report certain events when they occur.

What is a Qualifying Event? When do I become eligible for COBRA continuation coverage?

A "qualifying event" is an event that occurs which results in a loss of group coverage. Here is a list of qualifying events that make you eligible for COBRA continuation coverage:

  • Voluntary or Involuntary Termination of Employment* or Reduction of Hours.
  • Divorce or Legal Separation**.
  • Child Ceases to be a Dependent (e.g., child turns age 26).
  • Death of Employee.
  • Employee Becomes Entitled to Medicare.

* If the termination from employment is due to "gross misconduct", your department is not required to offer COBRA coverage. When a covered employee is terminated for gross misconduct, there is no qualifying event for the covered employee, spouse, domestic partner, or dependent children. None of these individuals are offered COBRA continuation coverage.

* Termination of Domestic Partnership. The state considers a covered domestic partner as a qualified beneficiary and may continue group coverage under COBRA.

How long may I be covered under COBRA?

Depending on the type of qualifying event you may continue group coverage for the maximum periods shown below.

Table of qualifying event and length of eligibility.

Table of qualifying event and length of eligibility.
Qualifying Event ​Length of Eligibility
​Voluntary or Involuntary Termination of Employment or Reduction of Hours (which causes loss of coverage) ​18 months
​Divorce or Legal Separation* ​36 months
​Child Ceases to be a Dependent (e.g., child turns age 26, child marries) ​36 months
​Death of Employee ​36 months


* Termination of Domestic Partnership. The state considers a covered domestic partner as a qualified beneficiary and may continue group coverage under COBRA.

** Active state employees do not lose their state-sponsored group dental and vision coverage at age 65 or entitlement to Medicare. The qualifying event "Medicare Entitlement" is listed under federal COBRA law, however, it will not have an affect on active employees state-sponsored dental and vision coverage. However, if a former state employee becomes covered under Medicare while enrolled in COBRA continuation coverage, then his/her COBRA coverage is terminated. COBRA continuation coverage for any covered dependents will not terminate for this reason.

When I retire from state service CalPERS continues my medical and dental coverage. Are state employees offered vision coverage under COBRA at the time of retirement?

Your personnel office is required to offer you COBRA to continue your active employee vision plan. The COBRA qualifying event is a voluntary or involuntary termination of employment.

The state also offers a Retiree Vision Program to employees that retire from state service. The Retiree Vision Program is fully paid by the retiree and a monthly deduction is taken from your retirement check.

If I don't want COBRA for myself may I elect continuation coverage for my dependents?

Each covered person whether an employee, spouse, domestic partner, or dependent child has independent election rights. If you don't want to elect COBRA, then the covered spouse, domestic partner, or dependent child have independent rights to elect COBRA continuation coverage.

How do I elect COBRA coverage?

When a covered individual experiences a "qualifying event", your department provides you and your eligible dependents a COBRA Election Notice and Election Form. The COBRA Election Notice informs covered individuals of their rights to elect continuation coverage because they are no longer covered under a group plan.

How does my HR Office become aware of a "Qualifying Event?"

Your personnel office is responsible to monitor timelines for COBRA elections and coverage continuation periods and ensure that eligible employees, spouses, domestic partners, and dependent children are provided required notices and advised of their COBRA rights and responsibilities.

Personnel staff are usually aware when a covered employee has died, voluntarily or involuntarily terminated employment, or reduced hours. However, the covered employee, spouse, and domestic partner has responsibility to notify the Human Resources office when a divorce, termination of domestic partnership, legal separation, or a child ceases to be a dependent occurs (e.g., child turns 26). At the time that one of these qualifying events occurs, the personnel office must receive notification within 60 days from the date of the qualifying event or the date on which coverage is lost.

If notification is provided timely, then a COBRA Election Notice and Election Form is provided to qualified beneficiaries. This notice is sent to qualified beneficiaries to explain their rights to elect COBRA continuation group coverage. If notice to the personnel office is not provided timely, the department is not required to offer COBRA continuation coverage.

How long do I have to elect COBRA continuation coverage?

Each qualified beneficiary has a maximum 60 day election period to elect continuation coverage. The last date to elect continuation coverage is reflected in the COBRA Election Notice. Each qualified beneficiary has independent election rights.

How much is the monthly COBRA premium? When is the premium due?

If COBRA is elected, the cost for coverage is 100% of the total premium, plus a 2% administration fee which is paid monthly by the enrollee to the plan or its designee. The plan or its designee is not required to send a monthly bill. Your department is not required to pay a share of the COBRA premium. You should contact your Human Resources office for the applicable premiums, plan names, and addresses where to send the monthly premiums.

Once COBRA is elected, the enrollee has 45 calendar days from the date of election to pay all retroactive premiums to the plan or its designee. The retroactive premium payment is the premium to cover the period from the date of loss of coverage to the date of election. All claims occurring during the months of retroactivity are held pending premium payment being made.

Once the retroactive premium is paid, future monthly premiums are due by the first of each following month. While due on the first, the enrollee has a maximum thirty (30) day grace period following the due date in which to make these premium payments. Human Resources pros hold all claims occurring during the month pending premium payment being made. If the applicable payment is not made within the grace period, then coverage is cancelled back to the end of the prior month in which a premium payment had been made. Once COBRA coverage is cancelled due to nonpayment of COBRA premiums the enrollee is not reinstated.

Where can I get more information?

If you need more information, check with your personnel office.

  Updated: 3/11/2020
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