Cal Cobra

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Steve Shorr Insurance

 

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Cal-Cobra SB 719 California Continuation Benefits Replacement Act §10128.50 et seq.  §1366.2     provides that you can keep the Employer Group Medical Coverage that you had on your former job, when there is a qualifying event, like losing your job, generally regardless of fault, a child getting older or divorce,  for 18 months, even if you were an owner or partner along with  employees of a small employer group (under 20 employees)  that was not covered by Federal COBRA.  When Federal COBRA expires you can now get an additional 18 Months - for a total of 36 AB 1401** If you worked for an Out of State Employer, then you might not qualify for the additional 18 months, but would qualify for guaranteed issue coverage under HIPAA, and your pre-existing conditions would be covered. §10128.59  We are unable to assist you in signing  up or applying  for  COBRA or CAL COBRA, unless your Employer is a client of ours.  You need to contact your former employer, or their Insurance Provider... Click here for the procedures.

When your COBRA or Cal COBRA 36 months runs out or terminates  per §10128.57 or if your former employer goes out of business,  then you can get Guaranteed Issue Medical Coverage under HIPAAMr. Mip might also be an option.  There's also Healthy Families for your kids.  Of course you can get coverage in the Preferred Market Place, subject to underwriting guidelines.  If you don't qualify, the rest of your family might.

 We suggest that you apply for a Regular Plan, as the application allows you to check off the box for Guaranteed HIPAA coverage, if you don't qualify for the preferred rates.   A big advantage to guaranteed plans is that Companies selling individual health insurance typically require a review of your medical history including pre-existing conditions  that could result in a higher premium or you could be denied coverage entirely.  AB 356 -  requires that you be given the reason for a denial and advised of Mr. Mip., Here's typical underwriting guidelines on the California Insurance Commissioner's website.

Procedures to get Cal-COBRA or COBRA

Check the Insurance Companies Administrative Manual, here's one for Blue Cross.  Just go thru the table of contents or Index and find the proper section and forms.   The Insurance Company should then send you the paperwork to sign up.  In larger companies it may be the HR department,  the owner of the business or the person in charge of the Insurance.  If you have any problems, getting them to understand that you're entitled to COBRA or CAL COBRA just tell them to take a look at the Law, cited above.  If you're a client of ours, then we can get you the forms to complete and send to the Insurance Company, to notify them of a  qualifying event i.e, the employee no longer works there.   The Insurance Company, will then send an "offer" - notification of COBRA rights, premiums, etc. to the former employee or dependent.  If you want us to write the letter for you... that would be a $125 consultation fee.

If you're late on a payment there is a grace period in accordance with law 10128.57 a 2  and the companies routine practices.

At one time there was  Senior COBRA (allowed for terminated employees over age 60 to be covered until age 65 - Medicare eligibility) but that was eliminated under AB 254 effective 1/2005, except for those who already have it.

Consumer Links

Explanation on Litter Labor Law Website

"Sample" probable underwriting Pre Existing Condition  form.

Disability Benefits 101.org

Are Out of State employer's subject to this law?

Blue Shield's Q & A on AB 1401 for total of 36 months  DMHC Q & A 1401

Department of Labor FAQ's

Blue Cross Small Group Employer's Administration Manual - Page 35   (Use search feature to check on COBRA & Cal COBRA procedures.)

Kaiser Cal Cobra Information Sheet Enrollment Form  Procedures

Health Net Employer Manual - do a search

Blue Shield COBRA Election Forms

Technical & Research Links

Don't Pick Up Cobra As Part of Your Next Deal - Negotiating COBRA Liability In Business Transactions  Kenneth W. Ruthenberg Jr. 9/10/2002 Employee Benefit Attorneys Article

AB 112 revises provisions relating to noncore coverage, such as dental or vision coverage.

 

 

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