Continuation of Coverage (COBRA)

When you no longer have active employee coverage, your health and welfare coverage needs do not necessarily end. Through COBRA, you and your family can extend coverage in certain instances where coverage would otherwise end due to specific qualifying events.

If you have any questions regarding COBRA Continuation Coverage or COBRA Open Enrollment, please contact the Employee Benefits and Services Division via email at ebsd@hr.sbcounty.gov, phone at 1.909.387.5552, or fax at 1.909.387.5566.

Resources and Forms


2017 Open Enrollment

COBRA Open Enrollment is June 1 - 23, 2017.  During this time, you have the opportunity to make the following changes effective for the new benefit plan year starting August 1, 2017:

  • Change your COBRA elected medical, dental, and/or vision plan(s)
  • Add or remove eligible dependents to or from your COBRA elected medical, dental, and/or vision plan(s)

Please note that you will not be able to make an election to participate in coverage that you have previously waived.  For more information, including rates effective August 1, 2017, please see the documents below:


How It Works

The County of San Bernardino, as required under provisions of the Consolidated Omnibus Budget Reconciliation Act (COBRA) of 1985, offers employees and their covered family members the opportunity to elect a temporary extension of coverage (called "continuation coverage" or "COBRA coverage") in certain instances where coverage would otherwise end due to certain qualifying events.

You can also continue coverage if:

  • Your spouse was covered but you are widowed or divorced
  • You were covered under your parents' group insurance plan while you were in school but you have since become ineligible due to your age or student status

You or your qualified beneficiary is responsible for the full applicable premium plus an administration fee of up to 2%.

Should an actual qualifying event occur in the future, the Employee Benefits and Services Division of the County's Human Resources Department will mail you additional information and the appropriate election notices at that time. The group health and welfare plans maintained by the County offer no greater COBRA rights than what the COBRA statute requires, and this summary should be construed accordingly.


COBRA Qualifying Events

Employees

If you are a County employee and are covered by the County's group health and welfare plans, you have the right to elect continuation coverage if you lose coverage under the plans due to any one of the following qualifying events:

  • Termination of your employment (for reasons other than gross misconduct)
  • Reduction in your employment hours
Spouses

If you are the spouse of an employee and are covered by the County's group health and welfare plans, you have the right to elect continuation coverage if you lose coverage under the plans due to any one of the following qualifying events:

  • The death of your spouse
  • The termination of your spouse's employment (for reasons other than gross misconduct) or a reduction in your spouse's hours of employment with the County
  • Divorce from your spouse
  • Your spouse becomes entitled to Medicare benefits
Dependent Children

In the case of an employee's dependent child who is covered by the County's group health and welfare plans, he or she has the right to elect continuation coverage if group health coverage under the plans is lost due to any one of the following qualifying events:

  • The death of the parent who is the County employee
  • The termination of the parent's employment with the County (for reasons other than gross misconduct) or reduction in the parent's hours of employment with the County
  • The divorce of the parent who is the County employee
  • The parent who is the County employee becomes entitled to Medicare benefits
  • The dependent child ceases to be a dependent child under the
    plan(s)

Notices and Elections

Under the COBRA statute, you or a family member has the responsibility to notify the Employee Benefits and Services Division of a divorce or a child losing dependent status under the County's group health and welfare plans.

This notification must be made within 60 days after the later of:

  • The date of the event, and
  • The date on which health and welfare plan coverage would be lost under the terms of the applicable insurance contracts because of the event

If you or a family member fails to provide this notice to the Employee Benefits and Services Division during this 60-day notice period, rights to continuation coverage will be forfeited.


COBRA Rights and Obligations

Each individual who was covered under the County of San Bernardino's group health and welfare plans on the day before the qualifying event is a "qualified beneficiary" and has independent election rights to continuation coverage.

This means that each covered dependent can elect independently to continue coverage, even if the covered employee chooses not to continue coverage. However, continuation coverage is available to qualified beneficiaries subject to their continued eligibility.

The Human Resources Division Chief, Employee Benefits and Services Division of the County of San Bernardino, or designee, reserves the right to verify eligibility status and terminate continuation coverage back to the original COBRA effective date if it is determined that an individual is ineligible or coverage was obtained through a material misrepresentation of the facts.

Under COBRA provisions, each qualified beneficiary can elect to continue all health and welfare plan coverage or any combination of coverage in which he/she was enrolled on the day before the event. For instance, a qualified beneficiary could elect to continue his/her group medical coverage and waive the continuation of his/her group dental coverage. The applicable premiums will vary depending on the coverage elected.

If you are covered by a region-specific HMO and are moving outside of the HMO service area, additional rights may be available to you at the time of the event. Please call the Employee Benefits and Services Division for additional information.

Once an election of continuation coverage is made, the coverage may change if modifications are made to the coverage provided to similarly situated non-COBRA plan participants or if an Open Enrollment period occurs.

Once enrolled, if your marital status changes, if a covered dependent ceases to be eligible for coverage, or if your address or that of your spouse changes, you must notify the Employee Benefits and Services Division immediately.

You will not be covered under the plan(s) during the election period. However, if a COBRA election is made as described in the Notice of Right to Elect Continuation of Group Health and Welfare Plan (COBRA) Coverage and all applicable premiums are paid as explained below, your health and welfare plan coverage selected will be reactivated back to your loss of coverage date in accordance with federal law.


Length of Continuous Coverage

If the original event causing the loss of coverage is any of the following … Then each qualified beneficiary will have the opportunity to continue coverage for …
Termination of employment (other than for reasons of gross misconduct) 18 months from the date of the qualifying event (please see Other Important Facts below)
Reduction in work hours
Death of the employee 36 months from the date of the qualifying event
Divorce
Dependent child ceasing to be a dependent child under the County's group health insurance plans

A qualified beneficiary is any individual who, on the day before a qualifying event, is covered under the County of San Bernardino's group health and welfare plans maintained by virtue of being on that day either a covered employee, the spouse of a covered employee, or a dependent child of a covered employee.


New Dependents and Open Enrollments

If, during the applicable period of COBRA coverage, an employee who elected continuation coverage acquires new dependents (such as through marriage), the new dependents can be added to the coverage according to the rules of the plan. Please note the following:

  • The new dependents do not gain the status of a qualified beneficiary and will lose coverage if the qualified beneficiary who added them to the plan loses coverage.
  • An exception to this is if a child is born to or adopted by an employee who has elected continuation coverage. If the newborn or adopted child is added to the covered employee's COBRA continuation coverage, then unlike a spouse or stepchild, the newborn or adopted child will gain the rights of all other "qualified beneficiaries."
  • The addition of a newborn or adopted child does not extend the 18- or 29-month coverage period. Plan procedures for adding new dependents are available by calling the Employee Benefits and Services Division. Premium rates will be adjusted at that time to the applicable rates.
  • Should an Open Enrollment period occur during your COBRA continuation period, you will be notified of your Open Enrollment rights. If an Open Enrollment period occurs, each qualified beneficiary will continue to have independent election rights to select any of the options or plans that are available to similarly situated non-COBRA plan participants.

California Continuation Rights

Coverage may be continued past the date when your federal (18 months) COBRA continuation coverage ends.

Health plans must offer individuals who have exhausted their initial 18 months (or 29 months for a disability extension) an extension under California law (called Cal-COBRA). This extension:

  • Is available for up to a total of 36 months (when combined with your 18 months of federal COBRA)
  • Applies to medical plans only (not dental or vision)

To obtain the extended coverage, you must notify your health plan in writing no later than 30 days before the end of the initial 18-month (or 29-month) period. If you elect this extension, you will notice an increase in the premium. Under Cal-COBRA, a health plan may charge an administration fee of up to 10%.


Cancellation of Continuation Coverage

COBRA continuation coverage will end prior to the expiration of the applicable 18, 29, 36, or 60 (in the case of a spouse covered under the California Continuation Rights extension) months of continuation coverage for any of the following reasons:

  • The County ceases to provide any group health plan to any of its active employees
  • Any required premium for continuation coverage is not paid in a timely manner
  • A qualified beneficiary obtains coverage, after the effective date of election, under another group health plan that does not contain any exclusion or limitation with respect to any pre-existing condition of the beneficiary other than an exclusion or a limitation that does not apply to (or is satisfied by) the beneficiary by reason of the Health insurance Portability and Accountability Act (HIPPA) of 1996
  • A qualified beneficiary becomes, after the date of the election, entitled to Medicare
  • A qualified beneficiary extended continuation coverage to 29 months due to a Social Security disability and a final determination has been made finding that the qualified beneficiary is no longer disabled (first day of the month after 30 days from the final determination)
  • A qualified beneficiary notifies the County that he or she wishes to cancel continuation coverage
  • For cause, on the same basis that the plan terminates for cause the coverage of similarly situated non-COBRA participants

Certificate of Health Insurance Portability

Your Certificate of Health Insurance Portability will be mailed separately to your home address. It will detail the amount of time you have been covered under the County's group health insurance plan(s).

Under the Health Insurance Portability and Accountability Act (HIPPA) of 1996, the time covered under the County's group health plan (including COBRA coverage, if elected) can be used to reduce a new health plan's pre-existing condition period. For example, if you were covered under the County's health plan for 10 months, including COBRA coverage, and your new health plan has a 12-month pre-existing condition clause for new participants, the new plan would subtract 10 months from the 12-month pre-existing condition period. However, for your coverage under the County's plan to be counted under a new health plan, there must be no break in coverage for more than 63 days from the time coverage under the County's plan (including COBRA coverage, if elected) ceases to the date of enrollment in your new plan.

Questions regarding a new health plan's pre-existing condition period and the impact HIPPA will have should be directed to your new health plan. If you obtain other insurance, present the Certificate of Health Insurance Portability to your new health insurance plan for determination if any benefits are available to you in this matter.

If you elect COBRA coverage, an updated Certificate of Health Insurance Portability will be sent to you when your COBRA coverage ceases. If you lose or do not receive the above-mentioned certificate, you can request one up to 24 months from the date coverage (or COBRA coverage) ceases by calling 1.909.387.5552.

County of San Bernardino © 2015. All rights reserved. | Privacy Policy | E-mail Webmaster | Disclaimer | Accessibility

157 West Fifth Street, First Floor • San Bernardino, CA 92415-0440 • Phone 909.387.5787 • TTY Users 711 • Fax 909.387.5566