DPA - Benefits - Benefits Administration Manual - Section 400: Consolidated Omnibus Budget Reconciliation Act (COBRA)

	Department of Personnel Administration
	Benefits Administration Manual
	Section 400 401. General Information 402. Qualified Beneficiary 403. Initial General COBRA Notice 404. COBRA Qualifying Events 405. Retiree Benefit Plan Alternate Coverage 406. Leaves of Absence 407. Loss of Group Coverage in Anticipation of a Qualifying Event 408. COBRA Election Notice and Election Form 409. COBRA Qualifying Event Notification Responsibilities 410. Notice of Unavailability of Continuation Coverage 411. Election Period 412. Length of COBRA Coverage 413. COBRA Premiums 414. Gross Misconduct 415. Noncompliance Penalties and Fines 416. Open Enrollment Period 417. COBRA in Retirement 418. Loss of COBRA Continuation Coverage 419. Completion of COBRA Enrollment Forms 420. Dental/Vision COBRA Premiums 421. Insurance Plan Addresses View all Section 400 Attachments Attachment A - Initial General COBRA Notice Attachment B - COBRA Election Notice Attachment C - COBRA Continuation Election Form Attachment D - Notice of Unavailability of Continuation Coverage Attachment E - Initial COBRA Notice Log Attachment F - COBRA Election Notice Log Attachment G - Monthly COBRA Status Report Attachment H - COBRA Calendar Navigation Table of Contents	Consolidated Omnibus Budget Reconciliation Act (COBRA) 417. COBRA in Retirement If a former spouse, domestic partner, or dependent child of a retired State employee experiences a COBRA qualifying event he/she will be offered COBRA continuation coverage through CalPERS. CalPERS retirees and their eligible dependents should contact CalPERS regarding COBRA notices and enrollment options.