Cal-COBRA vs. Federal COBRA: Principal Differences and How Each Program Works in CA

Post featured image
Back To Posts

Did you decide to leave your job but keep worrying about losing your group health plan? Getting another position sometimes means dealing with a short waiting period. The good news is that you can remain on your employer-provided coverage under COBRA.

California residents get to use two types of continuation coverage: the federal version of COBRA and Cal-COBRA. Let’s unpack that a little and examine the key differences and eligibility rules under both programs.

Cal-COBRA Overview

The first thing you need to know about this program is that it is a local CA version of the federal program. So, what is Cal-COBRA? It is a set of rules and requirements created to extend employer-provided coverage in case of a job loss, divorce, or death of your significant other.

Apart from protecting former staff members, the program also safeguards the dependents previously covered by a group plan.

How does COBRA work in CA?

While the traditional COBRA version offers coverage to companies employing more than 20 staff members, the CA version is available for smaller businesses. It can also be used by applicants who exhausted their federal continuation coverage.

The federal version has a lot in common with Cal-COBRA. Let’s say that a person decided to switch jobs in CA. In this case, sending a notice to the employee is a must for the employer. A notice typically includes all the essential information on the continuation program. The same applies to the CA version of the program.

While it might seem unappealing to work at a small company and then extend the offered coverage, it can have specific advantages. For instance, Cal-COBRA can apply to dental and vision coverage. Naturally, your company had to initially offer both options before you decided to opt-in for the CA version of COBRA.

How Long Does COBRA Last in California?

The duration differs when it comes to both coverage types. As for Cal-COBRA, it depends on the size of the company. So, as a California citizen working at a small company, you are likely to be qualified to extend your coverage with Cal-COBRA for 36 months.

There is also a way to extend your federal continuation coverage. For instance, if it lasted 18 months and you realized that you need another extension, you can apply for the CA version. But in this case, you should not expect Cal-COBRA to last longer than that.

The duration of a federal version, however, may vary depending on numerous factors like state laws.

What About the Costs?

Like the traditional version, the CA program requires applicants to pay all the premiums without the company’s assistance, including an administrative fee. It means that the Cal-COBRA cost can reach up to 150% of the set group rate, while the federal COBRA cost typically reaches 102%.

As for the benefits, every COBRA applicant typically receives coverage equivalent to the one previously offered by the employer. However, a company might decide to change the group plan and its terms. If that is the case, you should expect your continuation benefits to change.

In a nutshell, if you are about to lose coverage in California due to a job loss, divorce, or death of your significant other, any type of COBRA applies.

If you have lost your Cal-COBRA coverage for some reason or cannot afford it anymore, contact HICAP for further assistance.

Qualifying for the Program

By now, you should be familiar with the events that trigger the eligibility for both continuation programs — retirement, employment termination, and the death of a covered staff member.

But bear in mind that being disabled or experiencing several qualifying events at a time triggers specific regulations and extra disability extensions. To find out more about it, contact the U.S. Department of Labor.

Here are the general employee requirements allowing to qualify for any of the continuation programs:

Applying for Cal-COBRA can be a time-sensitive matter. That is why you need to pay attention to the requirements and deadlines. Applicants typically have 60 days to opt-in and only 45 days to make the first payment. If you miss the deadline, you will have to choose an individual plan.

FAQ

Is it possible to extend the COBRA coverage?

It definitely is possible. If you live in California and your federal coverage runs its course, you can apply for the CA version of COBRA. This way, you can get another extension.

It is also possible to extend the continuation coverage if you are disabled.

Can my COBRA coverage end prematurely?

Yes, it can, under the following circumstances:

Can I receive coverage from my ex-spouse?

Unfortunately, you cannot receive your ex-spouse’s employer-sponsored coverage. However, you can get a continuation. To do that, you need to inform a plan administrator within 60 days after getting a divorce or filing for separation. But bear in mind that you will have to bear all the costs.

Can I change my mind about waiving my right to COBRA coverage?

Yes, if you do that before the end of the election period. Otherwise, you will have to choose any of the suitable options through the exchange.


Written by:

Popular Articles