Continuation of Benefits Coverage (COBRA) - California

Summary of differences between federal and state regulations

The state laws have provisions that go beyond federal requirements. The state laws are called out below, and represent some areas where the state goes beyond the federal requirements under federal COBRA.

State

Contact

California Department of Insurance

Regulations

California has enacted provisions in response to the federal American Recovery and Reinvestment Act of 2009 (P.L. 111-5) in regard to COBRA continuation. See AB 23 and SB 838.

Cal-COBRA covers employer plans, including group policies of vision-only and dental-only coverage, with 2 to 19 eligible employees not covered by federal COBRA.

Eligibility for Cal-COBRA extends to indemnity policies, PPOs, and HMOs only. Self-insured plans are not eligible. Unlike COBRA, church plans are eligible under Cal-COBRA.

If employees become eligible for Cal-COBRA, they will have the benefit of Cal-COBRA coverage for a full 36 months. Cal-COBRA  provides a similar extension for those who have exhausted their 18 months on federal COBRA (or longer in special circumstances) for a total extension that cannot exceed 36 months.

Under Cal-COBRA special provisions have been made for seniors. These provisions are commonly referred to as Senior COBRA. If employees are 60 years or older at the time of their COBRA or Cal-COBRA qualifying event (for example, termination of employment) and have been employed five years or more with the employer sponsoring your group health insurance, then Senior COBRA can extend their coverage up to 5 years or until they reach age 65. Senior COBRA allows employees to maintain continuous coverage until they are eligible for Medicare. In order to be eligible for Senior COBRA, they must meet the qualifications for COBRA or Cal-COBRA and elect and exhaust the coverage.

Premiums may be up to 110 percent of the applicable rate charged for a covered employee.

If a qualified beneficiary is determined to be disabled, he or she must pay up to 150 percent of the group rate after the first 18 months of continuation coverage.

Group life insurance or disability policies must provide that in the event of a strike, employees covered by the policy, upon timely payment of the premium, must be covered for the period of cessation of work. The policy may provide that each individual premium rate must be increased by up to 20 percent.

California Insurance Code §10128.50-10128.59

California Health and Safety Code §1373.621 (scroll down the page to find the section)

California Health and Safety Code §1366.21, 1366.22, 1366.25, 1366.27

California Health and Safety Code §24100

Federal

Contact

Employee Benefits Security Administration (EBSA)

Regulations

26 CFR 54.4980B-1 et seq.