California health insurance    Health insurance options in California    Cobra coverage in California

A Quick Introduction to California Cobra and Cal-Cobra


Cobra health insurance in California Individual Family can be half the cost of Cobra if you're healthy
Cobra in California Make sure not to lose Cobra election window (more detail below)
California Cobra coverage
Some Californian's may have a Cal-Cobra extension period (below)
Cobra insurance in California You can generally "piece-meal" Cobra for any individual family member

Cobra and its California expanded version, Cal-Cobra refer to a set of laws that address the rights of employees coming off of group health insurance plans.  We can quickly get bogged down in the legal speak associated with any health-related law that comes out of Congress but let's try to boil it down so we can wrap our heads around the main points and how it affects your options in the California health insurance market.

Who is eligible for California Cobra Coverage?

First of all...in layman's terms...what is Cobra?  Essentially, Cobra is continuation of group coverage available to you and covered dependents after you leave a group plan.  You may be terminated or leave voluntarily.   There are only a few reasons Cobra might not be available such as termination due to fraud or gross misconduct.   Otherwise, if the health plans was a qualified group plan and remains intact, you may have a Cobra option even if you were only on the plan for 1 month.  What exactly does this mean?

Receiving and Electing Cobra Coverage

When you leave a group plan, the carrier or company (depending on it's size) will send you a Cobra option letter or packet.  You typically have 62 days from the last date of group health insurance (or upon receiving the letter but the letter should state the time-table) to elect Cobra with an effective date retro-active back to the last date of coverage (day after, actually).  This way, you can have continuous coverage.  Be careful...if you lapse this window without electing Cobra, the option is gone and Cobra is very strict about election and premium payment which brings us to the next key point.

Comparing California Cobra and Individual or Family insurance

With Cobra or Cal-Cobra, you pay the monthly premium yourself and the bills come directly to your address so make sure the prior carrier or administrator has the correct address on file.  The premium is typically 10% higher than what the carrier charged the group for smaller group.  Keep in mind that Cobra election may provide a qualifying event to change plans if other plans were available to the group.  You may use this time to downgrade coverage for example since California group health plans can be very expensive.  You can also piece meal Cobra in most situation.  For example, if you're in good health and can qualify for individual California health insurance but your spouse has health issues (regardless of whom the employee was), you can typically get Cobra for just the family members who might not qualify for individual health plans.  It's best to break out the price for each family member with your prior carrier or HR department if you need to piece-meal coverage.

Cal-Cobra can provide an additional 18 months after Cobra ends if eligible

Cobra typically lasts up to 18 months but you may also have a Cal-Cobra extension which can extend it to another 18 months.  The carrier or administrator should be able to confirm if a Cal Cobra extension is available.  Just make sure to use that terminology so they know what you're talking about.  Some situations (death, divorce, etc) may automatically result in a 36 month Cobra period anyway.  The coverage offered by Cobra will be identical to the plan you had through the company although the company may change plans (due to rate increase for example) during the course of the year and this may affect your plan as well. 

Group versus individual rates and health status are key to comparing Cobra

In terms of comparing Cobra and shopping for your own California individual health insurance plan, individual will usually be quite a bit cheaper for comparable coverage.  Until 2014, there's the question of qualifying based on health but if we can qualify, we'll generally get better rates on the individual market.  Just make sure not to lapse Cobra or the 62 day window before having a solid written confirmation of your approval on the individual plan for all family members at the rate you want.  If the company group plan is cancelled or the company goes out of business, the Cobra plan disappears as well.  You may then be eligible for HIPAA coverage.  We're happy to walk through your situation to see what is the best option.

 



 

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