• Voluntary or involuntary termination of employment, other than for gross misconduct;
• Reduction of hours; reduction of hours includes:
  • Full-time to part-time
  • Strikes
  • Layoffs
  • Leave of absence (if the leave results in a loss of coverage)
  • Military call-up (24 months of coverage)
  • Permanent Intermittent Employee (who loses coverage based on a non-qualifying control period)

Social Security Disability Extension to the 18-Month Period
The 18 months of continuation coverage can be extended for an additional 11 months of coverage, to a maximum of 29 months, for all qualified beneficiaries if the Social Security Administration determines a qualified beneficiary was disabled according to Title II or XVI of the Social Security Act at the time of the qualifying event or any time during the first 60 days of continuation coverage. This extended period allows disabled persons continued coverage for the period of time that it normally takes to become eligible for Medicare. Premiums for this coverage beyond the initial 18 months will be calculated at 150% of the State's group coverage premium rate and will continue to be paid monthly directly to the plan or its designee.

It is the qualified beneficiary's responsibility to obtain this disability determination from the Social Security Administration and provide a copy of the determination to the appropriate plan within 60 days after the date of determination and before the original 18-month COBRA eligibility period expires. It is also the qualified beneficiaries responsibility to notify the plan within 30 days if a final determination has been made that they are no longer disabled.

Special Medicare Entitlement Rule for Dependents Only
If an employee becomes entitled to Medicare benefits prior to the date of an 18-month qualifying event, then his/her dependents is eligible for 18 months of COBRA continuation coverage, or 36 months measured from the date of the Medicare entitlement, whichever is greater.

Example: If an employee becomes entitled to Medicare seven (7) months prior to termination of employment, then the dependents will be offered 29 months of continuation coverage. The employee is only offered 18 months.

SB 761 - Former State Employee Extension to the 18-Month Period (Repealed Effective January 1, 2005)
Another extension to the 18-month continuation period is available to any former State of California employee currently enrolled in COBRA and he/she was 60 years of age and an active employee for at least five prior years on the date that his/her employment ended. The extended COBRA period will provide uninterrupted coverage until age 65 or entitlement to Medicare. The spouse or domestic partner may extend the coverage for a period of five years from the date that the former employee's employment ends. Premiums for extended coverage for former employees beyond the initial 18 months will be calculated at 213% of the State's group coverage premium rate and will continue to be paid monthly directly to the plan or its designee. To elect, the former employee, spouse, or domestic partner must notify the plan within 30 days prior to the end of the18-month COBRA coverage period.

AB 254 Repeals SB 761 - Former State Employee Extension to the 18-Month Period
Under California law AB 254, the provisions of SB 761 were repealed for those individuals who meet the eligibility requirements of SB 761 after January 1, 2005. What this means is that if an employee experiences a qualifying event (i.e., termination of employment) on or after January 1, 2005, then the provisions of SB 761 are not available at the end of the 18-month COBRA continuation coverage.

AB 1401 - Extension of the Minimum COBRA Coverage Period
Under this California Law, employer-sponsored medical plans must allow an extension to COBRA coverage for an enrollee who has exhausted their initial 18 month continuation coverage period for up to 36 months from the date that coverage began. This provision will only apply to continuation of medical insurance COBRA coverage. In no event will continuation coverage last beyond three years (36 months) from the original date of loss of coverage. Premiums for extended coverage for former employees beyond the initial 18 months will be calculated at 110% of the State's group coverage premium rate and will continue to be paid monthly directly to the plan or its designee.

Secondary COBRA Event occurs during the 18-Month Period
If during the 18 months of continuation coverage, a second event takes place (divorce, termination of domestic partnership, legal separation, death, or a dependent child ceases to be a dependent), then the original 18 months of continuation coverage can be extended to 36 months from the original date of loss of coverage for eligible dependent qualified beneficiaries. If a second event occurs, it is the qualified beneficiary's responsibility to notify the plan in writing within 60 days of the second event and within the original 18-month COBRA timeline.

In no event will continuation coverage last beyond three years (36 months) from the original date of loss of coverage.

Group coverage can be continued under COBRA for 36 months if you lose coverage based one of the following "qualifying events":

• Death of employee;
• Divorce, legal separation, or *termination of domestic partnership; or
• Child ceases to be a dependent (i.e., child turns 23, child marries)
  * (State of California legislation)

Current as of January 1, 2008