Individuals Excluded from Cal-COBRA

Cal-COBRA does not apply to:

• Individuals entitled to Medicare benefits or who become entitled to Medicare benefits.
• Individuals with other hospital, medical or surgical coverage or who are covered by another group benefit plan, including a self-insured employee welfare benefit plan, which provides coverage for individuals and does not impose any exclusion or limitation on any existing condition of the individual, other than an existing condition limitation or exclusion that does not apply to or is satisfied by the qualified beneficiary. A group conversion option under any group benefit plan is not considered an arrangement under which an individual is covered.
• Individuals who are covered, become covered or are eligible for federal COBRA coverage.
• Individuals who are covered, become covered or are eligible for coverage pursuant to Chapter 6A of the Public Health Service Act.
• Qualified beneficiaries who fail to give notice of a qualifying event or election of continuation coverage within the specified time limits.
• Qualified beneficiaries who fail to submit the correct premium amount required in accordance with the terms and conditions of the plan contract or fail to satisfy other terms and conditions of the plan contract.

Cal-COCRA and Domestic Partners

Cal-COBRA treats registered domestic partners as qualified beneficiaries. If a registered domestic partner was a health plan participant on the day before a qualifying event, they would be entitled to continuation benefits.

The Cal-COBRA extension of federal COBRA continuation benefits would not apply to a registered domestic partner. A person must be a COBRA-qualified beneficiary to be entitled to an extension, and COBRA does not cover registered domestic partners. A registered domestic partner may be eligible to continue benefits through conversion to an individual policy.

Same-sex marriages are lawful under both federal and California law.

For information on federal and state coverage of same sex spouses, see Same-Sex Spouse and Domestic Partner Benefits.