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Consolidated Omnibus Budget Reconciliation Act (COBRA)

403. Initial General COBRA Notice

The Initial General COBRA Notice is the first of three required COBRA notices. Refer to Attachment A for a sample of the Initial Notice. The COBRA statute Requires that continuation coverage be offered to covered employees and dependents to continue group coverage in the event coverage is lost due to a qualifying event. The initial notice is intended to provide a summary of their rights, options, and notification responsibilities under COBRA. This is not the COBRA Election Notice.

The Initial General COBRA Notice contains the following information:

90-Day Notice Period

The initial notice must be provided to covered individuals "within 90 days after coverage begins". An exception to the 90-day rule is when a qualifying event occurs before the initial notice is provided, and then an initial notice must be provided along with the election notice and election form.

The Personnel Office is required to provide an initial notice to the covered employee, spouse, domestic partner, and covered dependent children (if any), of their rights under COBRA. Departments should customize the notice, depending on whether the employee is single, married, in a domestic partnership, or have dependent children. You may also customize the notice to identify more than one benefit to which there is an enrollment in coverage (e.g., medical, dental, and vision).

Important Note: The importance of the initial notice cannot be understated. If covered individuals lose group coverage in the future and later claim that they were not aware of their COBRA rights and notification responsibilities, then the Personnel Office will be able to prove that covered individuals were sent an initial notice. This notice provided information on their COBRA rights and notification responsibilities.

Single Notice Rule

A single notice sent first class mail to the last known address, is considered good faith compliance. The notice must be addressed to the employee, spouse and domestic partner. Notification to the covered spouse or domestic partner is deemed notification to the covered dependent children who reside at the same address (including any dependent children covered in the future). A separate notice is required when the Personnel Office is aware that covered individuals reside at a different address. Keep a copy in file of the actual notice sent.

Open Enrollment

If covered active employees add a spouse, domestic partner, and/or dependent children to their coverage (e.g., marriage, domestic partnership, loss of coverage, open enrollment period), then an initial notice must be provided to the newly covered spouse or domestic partner.

Changing to Another Plan

If an employee, spouse, domestic partner, or covered dependent children (if any), is covered under one employer group plan and changes from that plan to another plan of the employer, then a new initial notice must be provided (e.g., change from Delta Dental plan to a prepaid plan and/or prepaid plan to a Delta Dental plan).

Court Orders

If a Personnel Office receives a court order that requires enrollment of a child or spouse to an employee’s group coverage, then an initial notice must be sent.

Dependent Child: Send initial notice to the custodial parent or guardian ("in care of the child") or agency that sent the court order (as a substitute, if child’s address is unknown).

Spouse: Send initial notice to the spouse or agency ("in care of the spouse") that sent the court order (as a substitute, if spouse’s address is unknown). A court order that requires enrollment in group coverage for an ex-spouse is the responsibility of the employee, not the employer. The state does not allow enrollment of an ex-spouse on employees’ group coverage.

Approved Notice Delivery Methods

The COBRA statute disclosure regulations require that notices must be furnished using "measures reasonably calculated to ensure actual receipt of the material". The following are examples of acceptable distribution methods (first-class, second- or third class mail, hand-delivery, and electronic disclosure).

Mail Delivery

First Class Mail

First class mail is the evidentiary requirement. Proof of receipt is not required. A notice is presumed to have been received if mailed by first class to the last known address. There is a "presumption of receipt". However, the Personnel Office must be able to prove that the notice was sent in a manner that it is presumed to have been received or was reasonably calculated to be received by the qualified beneficiary. Reported non-compliance court cases generally conclude that, proof that the notice was mailed is more essential than, proof that the covered individuals actually received the notice.

Second and Third Class Mail

Although second and third class mail delivery (current postal terms are "Periodical and Standard Mail A) is acceptable, these postal classes do not provide the same guarantees regarding forwarding and return of mail, as does first class mail. Based on these types of inconsistencies, the tested and court approved first class mail delivery is recommended.

To prove that the notice was sent the Personnel Office should maintain a copy of the notice actually sent (reflecting the name(s) and address to which the notice was sent) and maintain evidence that the mailing practice was followed for each notice sent.

Hand Delivery

If the initial notice is provided to an employee by hand delivery, have the employee sign a statement acknowledging receipt of the notice. The initial notice can only be hand delivered to an employee and not to the employee's spouse, domestic partner, or dependent children. Hand delivery is not notification to a covered spouse, domestic partner, or dependent children. The Personnel Office is required to send a separate notice to the employee's spouse or domestic partner.

Electronic Delivery

If the disclosure requirements are satisfied and measures in place (including e-mail and other Internet based methods) that ensure actual receipt of the initial notice, then the use of electronic delivery is allowable. However, conditions which may not allow the use of electronic delivery include employees, former employees, covered spouses, domestic partners, or dependent children who do not have access to the department’s system (Even in situations where the Personnel Office has obtained permission from the employee, former employee, spouse, or domestic partner, to receive a notice at a particular home e-mail address, it cannot be assumed that they share an e-mail address).

Initial General COBRA Notice Log

The Initial General COBRA Notice Log is used to track the date and delivery method used to provide the notice. Refer to Attachment E for a sample of the Initial General COBRA Notice Log. You can also access this log as a fill and print document on DPA’s Web site at www.dpa.ca.gov (click on Benefits, then click on Dental or Vision Insurance, under Related Forms).

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