COBRA Continuation Coverage
The Consolidated Omnibus Budget Reconciliation Act (COBRA) provides retired members, non-member payees, and their dependents who lose ACERA-sponsored coverage the right to continue coverage for limited periods of time due to certain “COBRA-qualifying” circumstances. These events include the death of a covered member, divorce or legal separation from a retired member, eligibility for Medicare, and a child’s loss of dependent status (and therefore coverage) under the plan.
Electing COBRA Coverage
If you become entitled to elect COBRA continuation coverage, you have 60 days (starting on the date you are furnished a COBRA election notice or the date of your coverage loss, whichever is later) to elect COBRA continuation coverage.
Each individual who is affected by the qualifying event may
independently elect continuation coverage. This means that if you
and your dependents are entitled to elect continuation coverage,
you each may decide separately whether to do so. The covered
member or the spouse/domestic partner is allowed to elect on
behalf of any dependent children or on behalf of all of the
qualified beneficiaries; a parent or legal guardian may elect on
behalf of a minor child.
COBRA coverage is limited to a maximum of 36 months and the
following terms and conditions apply:
- COBRA premiums are calculated based on current monthly medical, dental, or vision plan rates plus a 2% administrative fee.
- You may only continue the coverage that was in effect on the date of the qualifying event.
- Coverage is extended only to those individuals covered at the time of the qualifying event.
- If you elect to continue coverage, you are responsible for the total cost of the premium plus any applicable administrative fee; ACERA will not supplement the cost. There are specific time constraints on when these premiums and administrative fees are due. Please contact ACERA’s COBRA administrator if you have questions.
To request continuation of coverage under COBRA, submit your request in writing to ACERA. Upon ACERA’s receipt of your COBRA continuation coverage request, ACERA’s COBRA administrator will provide you with enrollment forms and a letter summarizing your premium(s).
COBRA participants are subject to the same plan coverage levels
and administrative rules (e.g., adding dependents and changing or
cancelling coverage) that apply to non-COBRA participants.
When COBRA Coverage Ends
Continuation of coverage under any plan for you, your spouse/domestic partner, and dependent(s) will end on the earliest of the following dates:
- Reaching the end of the maximum eligibility period (36 months)
- The date ACERA ceases to sponsor a plan for any retiree
- Failure to make a timely premium payment
- The date you became covered under any other group health plan, whether through your or your spouse’s/domestic partner’s employment. (If this new group coverage contains limitations of coverage for pre-existing conditions, you may continue your COBRA coverage until the preexisting condition limitation ends or your right to continue COBRA coverage terminates.)
- The date you become covered by Medicare, ACERA will forward enrollment forms and a letter summarizing your premiums upon receipt of your request to continue coverage under COBRA and a final determination of your eligibility.