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  Navigation 		Consolidated Omnibus Budget Reconciliation Act (COBRA)

404. COBRA Qualifying Events

A "qualifying event" is an event that occurs which results in a loss of group coverage.

Qualifying Events Length of Coverage
18 Months 36 Months
Voluntary or Involuntary Termination of Employment (for reasons other than gross misconduct) or Reduction of Hours (which causes loss of coverage)* X  
Divorce or Legal Separation**   X
Child Ceases to be a Dependent (e.g., child turns age 23, child marries)   X
Death of Employee***   X
Employee Becomes Entitled to Medicare**** (under Part A, Part B, or both)   X

*Retirement is considered "Termination of employment"

* Reduction of hours includes:
  • Full-time to part-time, Strikes, Layoffs, Leaves of Absence (see Section 406), Permanent Intermittent Employee (who loses coverage based on a non-qualifying control period). Military call-up – 24 months of coverage (See "USERRA" Section 406).
** Termination of Domestic Partnership. The State will consider a covered domestic partner as a qualified beneficiary and may continue group coverage under COBRA.
*** 120-day death benefits apply, COBRA provisions are applicable after CalPERS determination of survivor benefits:
  • If CalPERS determines that family members are eligible for survivor benefits, then COBRA must be offered for vision coverage (since the survivors will be eligible to continue medical and dental benefits through CalPERS).

  • If CalPERS determines that family members are not eligible for survivor benefits, then COBRA must be offered for medical, dental, and vision benefits (since the survivors will not be eligible to continue medical, dental, and vision benefits through CalPERS).
The COBRA qualifying event is "death of employee", and the COBRA election notice and form must be sent within 14 days from the date that the 120-day death benefit ends.
**** Active State employees do not lose their State-sponsored group dental and vision coverage at age 65 or entitlement to Medicare. The qualifying event "Medicare Entitlement" is listed under federal COBRA law. However, it will not have an affect on active employees State-sponsored dental and vision coverage. If a former State employee becomes covered under Medicare while enrolled in COBRA continuation coverage, then his/her COBRA coverage may be terminated. COBRA continuation coverage for any covered dependents will not terminate for this reason. You should also read special Medicare entitlement rule for dependents in Section 412.

All qualified beneficiaries are eligible for COBRA continuation coverage, and may elect COBRA continuation coverage if group coverage is loss under the following conditions:

Qualifying Events for Covered Employee

A covered employee can elect COBRA coverage if he/she loses group coverage because of any of the following reasons:

  1. A voluntary or involuntary termination of employment (for reasons other than gross misconduct); or
  2. A reduction of hours (which causes loss of coverage).
Qualifying Events for Covered Spouse or Domestic Partner

A covered spouse or domestic partner can elect COBRA coverage if he/she loses group coverage because of any of the following reasons:

  1. A voluntary or involuntary termination of employee's employment (for reasons other than gross misconduct);
  2. Reduction of employee's hours (which causes loss of coverage);
  3. The death of employee;
  4. Divorce, termination of domestic partnership, or legal separation from employee; or
  5. The employee becomes entitled to Medicare (under Part A, Part B, or both).
Qualifying Events for Covered Dependent Children

A covered dependent child can elect COBRA coverage if he/she loses group coverage because of any of the following reasons:

  1. A voluntary or involuntary termination of the employee's employment (for reasons other than gross misconduct);
  2. Reduction of employee's hours (which causes loss of coverage);
  3. The death of employee;
  4. Parents divorce, terminate domestic partnership, or legally separate;
  5. The employee becomes entitled to Medicare (under Part A, Part B, or both); or
  6. A child ceases to be a dependent (e.g., child turns 23, child marries).
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