What is COBRA? When do I get a COBRA offer?

COBRA (Consolidated Omnibus Budget Reconciliation Act) is a law that allows employees and their dependents to continue health coverage after leaving employment, and in other situations for upto 18 months(36 months for qualified dependents). The following COBRA qualifying events should result in a COBRA offer:

Employee and all covered dependents receive COBRA:

•Termination of Employment
•Reduction of work hours

Only affected dependents receive COBRA:

•Dependent children turning age 26
•Divorce

Under COBRA law, the COBRA offer is physically mailed to the address on record. Ensure your address is current by updating your WorkDay profile or by contacting your HR supervisor.

Please note: the COBRA qualifying event must occur, and be recorded, before a COBRA offer can be made. Once a COBRA offer is made, there is 60 days to enroll into coverage. Under COBRA regulations, enrolled coverage must be continuous from the date of termination with no gaps or breaks in coverage.

When will I receive my COBRA package from the City?

It will take between 2 and 4 weeks for a COBRA package to be sent to the address you have on file in PaySR (payroll system) after the Employee Benefits Division receives notification of your COBRA qualifying event. We cannot provide forms early because we need to confirm that your benefits have terminated before completing the paperwork. Follow up with your HR supervisor or whoever is in charge of your payroll to ensure your employment records are up-to-date.

When will I have to pay for COBRA?

COBRA coverage is retroactive so - regardless of the date you elect COBRA coverage - you will have to pay COBRA premiums for all coverage from your termination date through the month your COBRA enrollment forms are received and processed by the insurance company. E.g. If your termination date was effective 1/1/24 and you enroll into COBRA effective 3/1/24, you are still responsible for premiums beginning 1/1/24 regardless if you used services or not.

How much does COBRA cost?

How does Medicare eligibility or Medicare enrollment affect COBRA eligibility?

If you have COBRA coverage before becoming Medicare eligible, you must terminate COBRA coverage when you become Medicare eligible. If you have Medicare before becoming COBRA eligible, you may elect COBRA coverage. For more information, please contact Medicare at 800-633-4227 and Social Security at 800-772-1213.

How do I enroll into COBRA?

After your COBRA qualifying event has been recorded, you will receive a COBRA package in the mail with pre-populated enrollment forms. Complete the forms for the benefits you wish to continue. You are not required to enroll in any/all coverages. (i.e. If you only want to keep medical coverage, complete the medical enrollment form only). However, once you miss the deadline to enroll, you are no longer eligible for COBRA coverage.

Could I enroll into a new/different coverage plan under COBRA?

No, you must enroll into the same coverage plan(s) prior to your COBRA qualifying event. You may only change your elections during COBRA Open Enrollment or if you experience a qualifying life event (E.g. If you were enrolled into Anthem PPO before your COBRA qualifying event, you cannot switch to Anthem Narrow Select HMO when enrolling into COBRA for the first time.)

Could I change my COBRA start date to another date?

No, COBRA coverage begins retroactively to the date you are no longer covered by the City to prevent any gaps in coverage even if you did not use services by the time you enrolled.

Could I terminate COBRA before the 18 month period? How do I terminate coverage?

Yes, COBRA covers eligible participants for up to 18 months under federal law.

To terminate coverage, please contact your benefit provider(s) directly to cancel your COBRA coverage. See Contact Information for COBRA section.

For Kaiser Members only:

In order to terminate COBRA coverage, you will need to submit a signed letter. The letter must include the requested termination date, reason for termination, and the subscriber’s signature. The requested term date will be subject to review and when the account is termed they will send a confirmation letter. You can mail or fax the letter to the following:

Kaiser Permanente
PO Box 23059
San Diego, CA 92193

Fax: 858-614-3344

When/How do I submit payment for COBRA premiums?

After you submit your enrollments directly to the benefit providers, you will receive instructions on how to make a payment. Do not send any payments to the City of Los Angeles/Employee Benefits Division. Under COBRA, you will make payments directly to the benefits provider.

My coverage has ended but I haven’t received my COBRA paperwork yet. Can I still see my provider?

Yes, since COBRA coverage is retroactive, you may see your providers after the COBRA qualifying event. If you receive a bill from the provider, you can submit it as a claim and receive reimbursement only after you’ve successfully enrolled into COBRA.

Contact Information for COBRA

The City will provide COBRA qualifying members with enrollment forms to initiate the enrollment process. After you’ve submitted your forms, the service providers will assist you for the duration of your COBRA coverage (e.g. billing questions).

Anthem

• Anthem Representative: Lorena Gomez

• Phone: 213-200-2987

• Email: Lorena.Gomez@anthem.com
  

Kaiser

• Phone: (323) 219-6704

• Email: LACity.Advocate@kp.org
  

Delta Dental

• Delta Dental’s COBRA company: iSolved

• Phone: 800-594-6957

• Email: crmail@isolvedhcm.com
  

EyeMed

• Blue View Vision's COBRA company: Lorena Gomez

• Phone: 213-200-2987

• Email: Lorena.Gomez@anthem.com

What is available to me?

If you are currently enrolled into COBRA continuation coverage as a result of a reduction in hours or an involuntary termination of employment, you may be eligible to receive reimbursements beginning the month of April 1, 2021 and continue to receive temporary premium assistance if the maximum period you would have been eligible for COBRA continuation coverage has not yet expired (if COBRA continuation coverage had been elected or not discontinued). If you were offered Federal COBRA continuation coverage as a result of a reduction in hours or an involuntary termination of employment, and you:

• declined to take COBRA continuation coverage at that time or
• elected Federal COBRA continuation coverage and later discontinued it,
  

then you may have another opportunity to elect COBRA continuation coverage and receive the premium assistance, if the maximum period you would have been eligible for COBRA continuation coverage has not yet expired (if COBRA continuation coverage had been elected or not discontinued).

Who is eligible to receive premium assistance?

To be eligible for the premium assistance, you must:

• have a COBRA qualifying event (reduction in hours or involuntary termination)
• enroll into COBRA coverage
• not be eligible for Medicare
• not eligible for coverage under any other group plan

How do I receive premium assistance?

If you experienced a COBRA qualifying event, you will or should have received a COBRA Notice letter in the mail with additional information regarding the ARP. To receive premium assistance, complete both of the following steps:

1. Complete and return the “Request for Treatment as an Assistance Eligible Individual Form” that is attached to the Summary of COBRA Premium Assistance Provisions under the American Rescue Plan Act of 2021 included in your COBRA Notice Letter to determine your premium assistance eligibility. Please send completed form to the Employee Benefits Division office at:
   
   Attn: COBRA Premium Assistance
   200 N Spring St. Room 867
   Los Angeles, CA 90012
   
   
2. Elect COBRA Coverage, if applicable. You will receive instructions and election forms to enroll into your previous coverage plan in your COBRA packet. Send election forms directly to the benefit provider(s), see mailing instructions below. Note: You cannot elect a new plan type.

Important notes to consider before enrolling into COBRA continuation coverage with premium assistance.

• The temporary premium assistance takes place from April 1, 2021 to September 30, 2021 only. You are responsible to pay for COBRA monthly premiums for the months you are covered outside of this time frame.
  • If your COBRA termination date ends before or during the temporary premium assistance period, you will not receive additional coverage and your benefits will terminate.
  • If your COBRA termination date ends after September 30, 2021, you will be responsible to pay for the monthly premium rates thereafter.
• You may select your COBRA effective date beginning from the date your benefits were terminated. For example, if your benefits terminated on November 30, 2020, you can select December 1, 2020 as your COBRA effective date. Note: You will be responsible to pay for premiums until April 1, 2021. Likewise, you can choose your COBRA effective start date to be April 1, 2021 and will not have to pay premiums for the months prior.