COBRA

The Consolidated Omnibus Budget Reconciliation Act of 1986 (COBRA) and the Omnibus Budget Reconciliation Act of 1989 (OBRA) require employers to continue Medical, Dental and Vision coverage for all eligible employees and dependents for up to 18, 29 or 36 months following certain events. The purpose of this continuation of coverage is to ensure access to health coverage for employees who would otherwise lose group coverage under specified circumstances called "qualifying events."

• COBRA ELIGIBILITY

  Employee Eligibility

  An employee covered by a CSU health, dental or vision plan has a right to choose continuation coverage if employer group coverage is lost because:

  1. Of a reduction in work hours; or
  2. The separation/termination of employment (other than due to gross misconduct).

  Spouse or Domestic Partner Eligibility

  A spouse or domestic partner of an employee, covered by a CSU health, dental or vision plan, has the right to choose continuation coverage if employer group coverage is lost for any of the following reasons:

  1. The death of the employee;
  2. Separation/Termination of employee's employment or reduction in employee's work hours;
  3. Divorce, legal separation, or dissolution of domestic partnership from the employee; or
  4. Employee becomes entitled to Medicare.

  Dependent Child Eligibility

  A dependent child of an employee covered by a CSU health, dental or vision plan, has the right to choose continuation coverage if employer group coverage is lost for any of the following reasons:

  1. The death of the parent (employee);
  2. The termination of the parent's employment or reduction in the parent's work hours with the CSU;
  3. The parents' divorce, legal separation, or dissolution of domestic partnership;
  4. The parent (employee) becomes entitled to Medicare; or
  5. The dependent ceases to be a "dependent child" under the CSU health plan.

  If an employee does not choose continuation coverage, the employee's coverage will end. However, the employee's spouse or domestic partner and/or eligible dependents may elect continuation coverage, independent of the employee's rejection.

• MONTHLY PREMIUM RATES

  COBRA monthly premiums are paid for by the participant directly to the insurance carrier.  The CSU does not pay any portion of the COBRA premium.  The rates are calculated at total monthly premium amount, plus 2% administrative fee.

  2025 COBRA Rate Sheet

• EFFECTIVE DATES OF COVERAGE

  COBRA coverage is effective the first of the month, following the date of the qualifying event (ie. separation date, reduction of hours).

  The CSU must notify eligible employees of their right to choose continuation coverage within fourteen (14) days of the qualifying event.

  The COBRA Continuation Notification will provide the start/end date of coverage, duration of coverage, those eligible for coverage and available plans.

  An employee's COBRA rights will be forfeited if the CSU does not receive notification of the employee's wish to continue coverage within sixty (60) days of the qualifying event or date of the notification.

  Following the sixty (60) day election period, an employee or eligible dependents have forty-five (45) days from the date of enrollment to pay for the continued coverage. The first payment will include the cost of coverage beginning with the first date coverage would have otherwise ended. After the initial payment, the required monthly premium is due before each month of coverage. Coverage will be canceled if payment is not received within the thirty day grace period following each payment due date. 

• CARRIER CONTACTS

  Medical

  CalPERS Customer Service Center
  Phone: (888) 225-7377
  Website: www.calpers.ca.gov

  Dental

  iSolved Benefit Services
  Phone: (800) 594-6957
  Website: www.isolvedbenefitservices.com

  Vision

  Vision Service Plan Customer Service
  Phone: (800) 400-4569
  Website: www.vsp.com

  Health Care Reimbursement Account

  ASIFlex Customer Service
  Phone: (800) 659-3035
  Website: www.asiflex.com

ADDITIONAL INFORMATION

Email hrbenefits@csusm.edu