The following are qualifying events that terminate employer-sponsored group health coverage, making you eligible for Cal-COBRA.

Employees

• Voluntary or involuntary termination of employment for any reason other than gross misconduct. For example, arson or embezzlement; or
• Voluntary or involuntary reduction in work hours below the minimum number of hours required to qualify for group health coverage.

Spouses

• Voluntary or involuntary termination of the covered employee's job for any reason other than gross misconduct;
• Covered employee is subject to a reduction in work hours below the minimum number of hours required to qualify for group health coverage;
• Covered employee becomes eligible for Medicare and no longer qualifies for the group health plan;
• Covered employee and spouse divorce or become legally separated; or
• Death of the covered employee.

Dependent Children

• Coverage is subject to the same rules as for spouses until the child reaches the age at which the child no longer qualifies for coverage under the parent’s group health plan.

You can use Cal-COBRA to continue your employer-sponsored health coverage initially for 18 months as an employee. Other periods of time apply for your spouse and children.

For the first 18 months, you are responsible for paying 110% of the total health insurance premium your employer may have been paying.

If you meet Social Security's rules for disability, Cal-COBRA can be extended to 29 months. However, you are responsible for paying a maximum premium of 150% for the additional 11 month extension.

The above amounts include the portion of premiums your previous employer may have paid.

Note: Previously, an individual would utilize OBRA after COBRA coverage ends. However, for qualifying events occurring on or after January 1, 2003, Assembly Bill No. 1401 extends Cal-COBRA coverage by an additional 18 months giving individuals 36 months of coverage or until Medicare eligible. With AB 1401 you pay 102% of the premium payment, rather than 150% with OBRA.

Other components of AB 1401 include:

• Requires former employers and health insurance carriers to continue providing coverage to previous employees.
• Additional 18 months of coverage applies to Health Maintenance Organizations (HMOs) and health insurance (PPO, POS, indemnity plans, etc.)
• Allows former employees an additional 18 months of coverage, regardless of disability status.
• Allows individuals to retain coverage who become disabled after a qualifying event occurs. An individual no longer needs to provide a Social Security Award Letter for extended coverage, if covered by an HMO or health insurance.
• Law does not apply to self-insured trusts/self-funded plans.

However, the Cal-COBRA extension is for people who left the workforce due to a Social Security level of disability.

You are eligible for a Cal-COBRA extension if:

If you decide to elect Cal-COBRA, you will be given an additional 45 days to pay any premiums that are due or became due before you elected Cal-COBRA.

Your employer may choose a company to process Cal-COBRA premiums, called a Cal-COBRA administrator.

• You have had at least 18 months of previous group coverage;
• You are no longer eligible for COBRA and not eligible for any other health coverage, including Medi-Cal or Medicare; and
• You have had coverage within the past 63 days.

• If you become eligible for Medicare while you are eligible for Cal-COBRA, your Cal-COBRA eligibility ends.
• If you are already eligible for Medicare at the time of a qualifying event, you may qualify for Cal-COBRA.

OBRA is a federal law that allows an employee to continue health insurance benefits after COBRA ends, if the employee has elected COBRA coverage due to a Social Security approved disability.

Cal-COBRA is California health coverage protection that requires employers of 2 to 19 employees to provide their employees (and their dependants) the right to continue health insurance benefits when a qualifying event occurs.