COBRA Continuation Coverage
The Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA), is a Federal law that requires employers to offer you and your dependents the opportunity to temporarily continue your medical, dental, vision, and/or Health Care FSA coverage at your own expense after your District-sponsored coverage ends. Every employee has the right to choose continuation of coverage if the employee loses his/her health coverage due to a reduction in hours, resignation or termination of employment (for reasons other than gross misconduct on the part of the employee).
To continue coverage under COBRA, you must pay a monthly premium. The actual premium amount is determined annually and will not exceed 102% of the premium paid by the District for employees and/or dependents in a comparable status.
Permanent Employees:
If you are a permanent employee in a regular assignment, and become unpaid for an entire month, you will be offered the option of continuing your coverage under COBRA. Employees on unpaid leaves of absence under the Federal Family Medical Leave Act retain District-sponsored coverage for up to 12 weeks.
Substitute Employees:
Substitutes who lose benefits at the end of a school year because they did not work 100 days in the previous fiscal year or become unpaid for an entire month are eligible to continue coverage under COBRA.
COBRA is automatically generated once an employee’s benefits are terminated. Should you need assistance, contact: FBMC, the COBRA/AB528 Administrator, at 800-342-8017 or by visiting http://www.fbmc.com
In order to elect COBRA in a timely manner, you or a family member must notify the Benefits office within 60 days in the event of:
• Your divorce;
• Your child ceasing to qualify as a dependent under the District’s plan(s);
• Your death.
LAUSD will notify the COBRA Administrator in the event of:
• Your resignation or dismissal (except in cases of gross misconduct);
• Your loss of benefits due to a reduction of your assigned hours (including taking an
approved unpaid leave.) Upon receipt of notification, you will be mailed a COBRA election packet. Failure to notify the District within 60 days will forfeit your right to elect COBRA. In general, employees may continue coverage under COBRA for 18 months, while dependents may continue for 36 months.
Cal-COBRA is a California law that is similar to Federal COBRA. If your 18 months of Federal COBRA ends, you may be able to continue your health insurance under Cal-COBRA for an additional 18 months, for a total of 36 months. If your COBRA lasted 36 months, you are ineligible for additional Cal-COBRA coverage. Coverage under CalCOBRA is available for medical benefits only. If you are enrolled in Kaiser or Health Net, please contact the plans directly for information regarding Cal-COBRA benefits. For information regarding CAL-COBRA for the Anthem Blue Cross Select HMO & Anthem Blue Cross EPO, contact FBMC at 800- 342-8017 or by visiting http://www.fbmc.com/Default.aspx
AB528 is a District program that may allow your surviving spouse to continue his/her coverage once COBRA eligibility ends. Employees who retire and are not eligible for life-time benefits are also eligible for AB528.
- Your domestic partner and children of your domestic partner are not eligible for continuation of coverage through COBRA or AB528. (If you are registered with the State of California, then your domestic partner and his/her children may be eligible for Cal-COBRA).
- Your dependent children are not eligible for continuation of coverage through AB528.
- You may change your health care elections during the District’s annual enrollment period held each November and if you move of out of state/out of the service area for your particular plan or upon reaching the age of 65.
Please Note:
- There is no reinstatement of coverage after cancellation of COBRA/AB528 coverage.
- You must adhere to the timeframes for enrolling in your coverage. You have 60 days to notify the administrator of your intent to enroll in the COBRA or AB528 coverage. If you miss this deadline, you will lose your right to enroll in benefits.
FBMC
California Department of Insurance (CDI)
State agency with information on COBRA
1-800-927-4357 (many languages)
1-800-482-4833 (TTY)
www.insurance.ca.gov
U.S. Department of Labor COBRA
Information on the Federal COBRA program to help you keep group health insurance if you lose your job or your hours are cut
1-866-444-3272 (Spanish, Chinese)
1-877-889-5627 (TTY)
www.dol.gov/dol/topic/health-plans/cobra.htm or www.dol.gov/ebsa
Major Risk Medical Insurance Program (MRMIP)
Provides Health insurance if you are unable to get coverage because of your pre-existing conditions. To get a program handbook or application
1-800-289-6574
www.mrmib.ca.gov/MRMIB/MRMIP.html
