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.