Health Benefits Changes & Employee Rights Under ERISA

Updated January 18, 2026

How to Get COBRA Health Insurance in California: A Simple Step-by-Step Guide [With Examples]

Suddenly losing your health insurance when you leave a job can be overwhelming. COBRA health insurance offers a lifeline when you're between jobs or transitioning to new coverage, but navigating the enrollment process often feels confusing.

Fortunately, while COBRA might seem complex at first, the process follows a clear structure in California. This coverage allows you to maintain the exact same health benefits you had with your employer—though you'll now be responsible for the full premium cost.

In California specifically, eligible employees have additional protections beyond the federal COBRA law through Cal-COBRA, which covers employees at smaller companies with 2-19 workers.

This step-by-step guide will walk you through the entire COBRA enrollment process in California, from understanding your eligibility to making your first payment. We'll clarify each stage with practical examples so you can maintain your health coverage without unnecessary stress or confusion.

Step 1: Understand What COBRA Is

COBRA stands for the Consolidated Omnibus Budget Reconciliation Act, a federal law established in 1985 that provides a crucial safety net for health insurance during life transitions . This temporary continuation of health coverage serves as a bridge between employment-related insurance plans, ensuring you don't experience dangerous gaps in medical care.

What COBRA covers and who it applies to

COBRA health insurance maintains the exact same benefits you enjoyed under your employer's plan. This means you keep identical coverage, including the same network of doctors, hospitals, deductibles, and coverage limits . Furthermore, any changes made to the plan for active employees automatically apply to those with COBRA coverage .

The law applies primarily to private-sector employers with 20 or more employees and state/local government employers . Both full-time and part-time workers count toward this threshold, with part-timers counted as a fraction based on their hours worked compared to full-time status .

Several categories of people qualify as beneficiaries under COBRA:

• Former employees
• Retirees
• Spouses and former spouses
• Dependent children (including those born to or adopted by the employee during COBRA coverage)
• Children born to or adopted by the covered employee during the continuation period

To trigger COBRA eligibility, one of these qualifying events must occur:

• Job termination (for reasons other than gross misconduct)
• Reduction in working hours
• Death of a covered employee
• Divorce or legal separation from a covered employee
• Medicare eligibility for a covered employee
• Loss of dependent child status under the plan

The duration of COBRA coverage depends on your specific qualifying event, typically lasting 18 months for job termination or reduced hours, and up to 36 months for other qualifying events .

How it relates to ERISA and California law

COBRA health insurance provisions directly amend the Employee Retirement Income Security Act (ERISA), the Internal Revenue Code, and the Public Health Service Act . Consequently, when dealing with continuation coverage in California, you're navigating both federal and state regulations.

A notable court decision highlighted that even state continuation coverage like Cal-COBRA falls under ERISA's governance if the underlying plan is governed by ERISA . This means employers must fulfill ERISA fiduciary responsibilities for both federal and state continuation coverage, particularly regarding notification requirements .

California offers additional protection through Cal-COBRA, which differs from federal COBRA in two significant ways:

1. Employer Size: Cal-COBRA covers employers with 2-19 employees, extending protection to workers at smaller companies .

2. Coverage Duration: Cal-COBRA can extend coverage beyond federal COBRA's limits. Additionally, if you exhaust 18 months of federal COBRA, California law allows you to extend coverage for another 18 months under Cal-COBRA, providing up to 36 months of total coverage .

Unlike some specialized coverage (such as disability or life insurance), COBRA strictly applies to health benefits, including medical, dental, and vision plans that were part of your original coverage . Once enrolled, you cannot choose new coverage or change your plan to a different one .

California Workers: Call Setyan Law at (213)-618-3655 to schedule a free consultation.

Step 2: Check If You’re Eligible for COBRA in California

Before enrolling in COBRA health insurance, verifying your eligibility under California law is essential. California offers broader protections than many other states, often allowing more workers to access continuation coverage through combined federal and state programs.

Qualifying events that trigger COBRA

Qualifying events are specific circumstances that result in loss of employer-provided health coverage. In California, these events must meet certain criteria to trigger eligibility:

For employees, qualifying events include:

• Voluntary or involuntary termination of employment (except for gross misconduct)
• Reduction in work hours that causes loss of benefits eligibility
• Transitioning from full-time to part-time status

For spouses and dependents, additional qualifying events include:

• Death of the covered employee
• Divorce or legal separation from the covered employee
• Employee becoming entitled to Medicare
• Loss of dependent child status under plan rules (typically upon reaching age 26)

Each qualifying event establishes a specific maximum coverage period. Generally, employment termination or reduced hours provide 18 months of coverage, whereas death, divorce, Medicare entitlement, or loss of dependent status offer up to 36 months of continuation coverage.

Who in your family can be covered

COBRA eligibility extends beyond just the employee to qualified beneficiaries—individuals covered by the group health plan on the day before the qualifying event occurred. Accordingly, eligible family members include:

• The employee's spouse or registered domestic partner
• Dependent children (biological, adopted, or placed for adoption)
• Stepchildren and foster children who qualify as dependents

Notably, each qualified beneficiary has independent election rights. This means your spouse or dependent children can choose COBRA coverage even if you decline it. They also maintain the right to select different coverage options if multiple plans were previously available.

Furthermore, children born to or placed for adoption with the covered employee during the COBRA coverage period automatically become qualified beneficiaries. This protection ensures new family members aren't left without insurance options.

Special rules for California residents

California enhances federal COBRA protections through Cal-COBRA, creating a more robust safety net for residents. These special rules primarily benefit employees of smaller companies and those needing extended coverage:

First, Cal-COBRA covers employers with 2-19 employees who are exempt from federal COBRA requirements. This extension ensures small business employees receive similar protections as those working for larger companies.

Second, Cal-COBRA allows for coverage beyond federal COBRA's limits. Once you exhaust the 18 months of federal COBRA coverage, Cal-COBRA permits an additional 18 months, providing up to 36 months of total continuation coverage.

Third, California law provides special protections for disabled individuals. If you're determined disabled by the Social Security Administration within the first 60 days of COBRA coverage, you may qualify for an 11-month extension beyond the standard 18 months under federal rules.

Prior to making decisions about enrollment, request detailed information from your employer or plan administrator regarding your specific eligibility under both federal COBRA and Cal-COBRA provisions. The plan administrator must verify your qualifying event and confirm your eligibility status within 14 days of notification.

Remember that verification of eligibility differs between federal COBRA and Cal-COBRA. Under federal COBRA, your employer handles the process, whereas under Cal-COBRA, the insurance carrier typically manages eligibility determinations and enrollment procedures.

Step 3: Review Your COBRA Election Notice

After determining your eligibility, the next crucial step is reviewing your COBRA election notice. This document serves as your official invitation to continue your health coverage and contains critical information about your rights and responsibilities.

What the notice must include

The COBRA election notice contains essential details that help you make an informed decision about continuing your health coverage. By law, this notice must include:

• A detailed explanation of your rights and obligations under COBRA
• The specific date your coverage would otherwise terminate
• Instructions on how to formally elect COBRA coverage
• The monthly premium amount and payment schedule
• The maximum period of continuation coverage available to you
• Information about the consequences of not electing coverage
• Contact information for the COBRA plan administrator
• The deadline by which you must make your election

This notice should provide all necessary information to understand your options, costs, and the steps required to maintain your health coverage.

When and how you'll receive it

The timing of your election notice depends on who administers your COBRA benefits. If your employer handles notification:

• The employer must notify the plan administrator within 30 days of your qualifying event
• The plan administrator then has 14 days to send you the election notice
• When the employer also serves as plan administrator, they have a maximum of 44 days from the qualifying event to provide the notice

Election notices must be sent via first-class mail or delivered in person to your last known address . Some administrators may offer secure digital delivery options . For qualifying events like divorce or a dependent aging out, the notice is sent after the plan administrator receives notification of these changes.

What to do if you don't get one

If your election notice doesn't arrive within the required timeframe:

1. Contact your employer or plan administrator immediately to request your notice
2. For federal COBRA issues, reach out to your employer
3. For Cal-COBRA concerns, contact your health plan directly
4. If necessary, engage the Department of Labor for assistance with non-compliance

Remember that failure to receive a notice doesn't extend your 60-day enrollment window . Acting promptly is crucial, as missing the deadline could result in losing your chance to enroll in COBRA altogether .

Significantly, employers who fail to provide timely notice may face penalties of up to $110 per day . Moreover, courts have established that providing appropriate notice is a fundamental requirement under COBRA law .

If your notice is returned as undeliverable, good plan administrators will attempt to locate you through alternative means, including checking with your insurer, other departments, or even former coworkers.

Step 4: Decide Whether to Enroll

Once you receive your COBRA election notice, the clock starts ticking on one of the most important healthcare decisions you'll make. Making an informed choice requires understanding your timeframe, options, and financial considerations.

How long you have to decide

After receiving your COBRA election notice, you have exactly 60 days to decide whether to enroll . This two-month window gives you time to evaluate your options, although your coverage will remain active during this period. Indeed, even if your enrollment is delayed within this timeframe, your coverage will still be backdated to begin on the day your prior coverage ended .

Subsequently, after submitting your enrollment form, you have an additional 45 days to make your first premium payment . Missing either deadline could result in permanent loss of your COBRA eligibility. Remember to:

• Submit your enrollment form before the 60-day deadline
• Send it to the correct address
• Include the accurate premium amount
• Make your first payment within the 45-day window

How to compare COBRA with other options

Instead of automatically choosing COBRA, consider these alternatives:

1. Marketplace Plans: You can enroll in a Covered California plan within 60 days before or after your employer coverage ends . Often these plans cost less than COBRA, especially if you qualify for subsidies .

2. Medicaid/CHIP: If eligible, you can enroll in these programs anytime, with coverage starting immediately .

3. Medicare: If you're Medicare-eligible, weigh whether COBRA or Medicare with a supplemental policy offers better value for your situation .

Essentially, your decision should consider:

• Network of doctors and hospitals in each plan
• Total monthly premiums for you and dependents
• Copays and deductibles in various plans

Cost considerations and premium breakdown

COBRA is typically expensive since you'll pay the entire premium that both you and your employer previously paid, plus a 2% administrative fee . For example, in 2017, the average annual premium for employer-sponsored health insurance was $6,690 for an individual and $18,764 for a family .

California COBRA premiums vary by region. For instance, 2019 rates for Kaiser coverage ranged from:

• $631.01 (single) to $1,640.63 (family) in Los Angeles
• $783.62 (single) to $2,037.40 (family) in the Bay Area

For disabled individuals who qualify for the 11-month extension beyond the standard 18 months, the premium increases to 150% of the plan premium for months 19-29 .

When comparing costs, remember that while COBRA preserves your existing coverage and network, Marketplace plans often cost significantly less, with 80% of people qualifying for financial assistance .

Step 5: Enroll and Make Your First Payment

The final phase of securing COBRA health insurance involves properly submitting your election form and making your first payment correctly and on time.

How to fill out the election form

Upon receiving your COBRA notice, review the election form carefully. Complete all required fields, including:

• Personal information for all qualified beneficiaries
• The specific plan options you're electing
• Your signature and date

Double-check everything before submission as incomplete forms may delay your coverage. Remember, you must submit this completed form within 60 days after receiving your COBRA election notice .

Where to send your payment

Initially, send your enrollment form to the address specified in your election notice . The form must indicate precisely where to direct your payment—either to your former employer, insurance carrier, or a third-party administrator.

Following your enrollment submission, you have 45 days to make your first premium payment . This initial payment covers the retroactive period from when your original coverage ended through the current month .

Subsequent monthly premiums are typically due on the first day of each coverage month, with a standard 30-day grace period .

What happens if you miss the deadline

Missing either deadline has serious consequences. If you fail to submit your election form within the 60-day window, you permanently lose your right to COBRA coverage . Similarly, if your first payment isn't received within the 45-day timeframe, all continuation coverage rights under the plan terminate .

Once COBRA coverage is canceled due to nonpayment, reinstatement is not possible .

Conclusion

Navigating COBRA health insurance in California requires attention to specific timelines and procedures, but following this step-by-step approach makes the process manageable. Understanding your eligibility under both federal COBRA and Cal-COBRA gives you a clear picture of your options, especially since California offers extended protections for residents of smaller companies.

After receiving your election notice, you have exactly 60 days to make your decision, followed by 45 days to submit your first payment. Although COBRA preserves your existing health coverage seamlessly, comparing it with alternatives like Covered California marketplace plans, Medicaid, or Medicare might reveal more cost-effective options for your specific situation.

Remember that each qualified beneficiary has independent election rights, allowing family members to make separate coverage decisions based on their needs. Most importantly, missing any deadlines permanently eliminates your COBRA eligibility, making timely action essential.

COBRA serves as a valuable safety net during employment transitions, ensuring you maintain consistent health coverage during uncertain periods. While the premiums might seem substantial compared to employer-subsidized insurance, the continuity of care and familiar provider networks often justify the investment until you secure new coverage.

The peace of mind that comes from uninterrupted health insurance coverage during major life changes is undoubtedly worth the effort of understanding and properly executing the COBRA enrollment process. Armed with this knowledge, you can confidently maintain your health benefits and protect yourself and your family during employment transitions.

References

[1] – https://www.coveredca.com/support/before-you-buy/cobra/
[2] – https://www.dol.gov/agencies/ebsa/laws-and-regulations/laws/cobra
[3] – https://hrmanual.calhr.ca.gov/Home/ManualItem/1/1408
[4] – https://www.dmhc.ca.gov/HealthCareinCalifornia/TypesofPlans/KeepYourHealthCoverage(COBRA).aspx
[5] – https://www.nfp.com/insights/court-finds-erisa-applies-to-state-continuation-coverage/
[6] – https://www.ambetterhealth.com/en/oh/learn-more/cobra-vs-health-insurance-marketplace-faq/
[9] – https://www.cms.gov/cciio/programs-and-initiatives/other-insurance-protections/cobra_qna
[11] – https://www.healthcare.gov/unemployed/cobra-coverage/
[12] – https://cahealthadvocates.org/other-health-insurance/cobra-calcobra-insurance/
[13] – https://www.calpers.ca.gov/sites/default/files/spf/docs/2019-cobra-regional-rates.pdf
[14] – https://www.dol.gov/sites/dolgov/files/EBSA/laws-and-regulations/laws/cobra/model-election-notice.docx
[15] – https://www.myshyft.com/blog/cobra-notice-deadline-long-beach-california/
[16] – https://benefits.calhr.ca.gov/state-employees/general-benefits/cobra/

California Workers: Call Setyan Law at (213)-618-3655 to schedule a free consultation.

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