Q.Who is eligible for Cal-COBRA?
A.The employee and his or her spouse and dependent children become eligible for Cal-COBRA when the employee is terminated or quits for any reason other than: (1) gross misconduct or (2) a reduction in work hours such that the covered employee fell below the minimum number of hours required to qualify for group health coverage. Gross misconduct is tantamount to illegal or dangerous acts committed in the workplace that go beyond mere negligence or incompetence such as sex crimes, grand theft or arson.
A spouse and dependent children of a covered employee may also become eligible for Cal-Cobra if the covered employee becomes eligible for Medicare and no longer qualifies for the group health plan, or there is a divorce, or legal separation.
Employees and their dependent spouses and children who are enrolled in the employer's employee benefit plans at the time of a qualifying ("qualified beneficiaries") and are eligible for Cal-COBRA, unless the individual:
- fails to notify the health provider of the qualifying event (e.g. termination, death, divoice, legal separation) entitling them to cobra benefits within the time specified by the law (generally 60 days);
- becomes covered under another health plan which does not impose any pre-existing condition limitations affecting the individual;
- becomes eligible for federal COBRA;
- becomes eligible for Medicare;
- becomes eligible for Medi-Cal; or
- fails to pay the premium on time.