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COBRA

COBRA Benefits

Under the federal Consolidated Omnibus Budget Reconciliation Act (COBRA), if you don’t have holdover rights or if your holdover rights have ended, you may still be eligible to continue your medical, dental, and vision coverage for yourself and your eligible dependents at your own expense. Current-year FSAs (Flexible Spending Accounts) may also be COBRA-eligible. For COBRA information, visit padmin.com or call (800) 688-2611.

You may elect to continue healthcare coverage through COBRA if coverage is lost due to:

  • Voluntary or involuntary termination of employment (except for gross misconduct)
  • Hours of employment reduced, making employee ineligible for employer health coverage

Your covered spouses or domestic partners may also elect to be covered under COBRA if coverage loss is due to:

  • Voluntary or involuntary termination of the employee’s employment (except for misconduct)
  • Divorce, legal separation, or dissolution of domestic partnership from the covered employee
  • Death of the covered employee

Your covered dependent children may elect COBRA coverage if healthcare coverage is lost due to:

  • Loss of dependent child status under the plan rules
  • Voluntary or involuntary termination of the employee's employment (except for misconduct)
  • Hours of employment reduced, making the employee ineligible for employer health coverage
  • Parent’s divorce, legal separation, or dissolution of domestic partnership from the covered employee
  • Death of the covered employee

COBRA Notification and Election Time Limits

If you and any enrolled dependents lose SFHSS coverage due to separation from employment, P&A Group will notify you of the opportunity to elect COBRA coverage. You or your dependent has 60 days from the COBRA notification date to complete enrollment and continue coverage. Coverage will be retroactive to the date of the COBRA-qualifying event, so there is no break in coverage. Your coverage ends on the last day of the coverage period in which your employment terminates. However, if your termination date falls on the first day of the coverage period, your coverage ends that same day. If your enrolled dependent loses coverage due to divorce, dissolution of partnership, or aging out, you or your dependent must notify P&A Group within 30 days of the qualifying event and request COBRA enrollment information.

Paying for COBRA

If you are a covered individual enrolled in COBRA, you are responsible for paying your required health insurance premium payments directly to P&A Group. Your employer does not subsidize COBRA premiums.

Duration of COBRA Continuation Coverage

If you enroll in COBRA coverage, it is generally available to you for up to 18 months. However, certain qualifying events or a second qualifying event that occurs during your initial coverage period may allow you to extend your coverage for up to 36 months.

If you are eligible for less than 36 months of federal COBRA, you may also qualify for Cal COBRA. In any case, your total continuation coverage under both federal and California COBRA cannot exceed 36 months.

If you are disabled on the date of your qualifying event or become disabled within the first 60 days of COBRA coverage, you may be eligible for up to 29 months of coverage. Starting in the 19th month, your premium cost will increase to 150 percent of the group rate.

Flexible Spending Accounts and COBRA

To continue your FSA benefits under COBRA, your year-to-date contributions must exceed your year-to-date claims as of your employment termination date. To keep your FSA active, you must enroll in COBRA and continue making your biweekly contributions along with a 2 percent administrative fee. Your COBRA Flexible Spending Account contributions will be made on a post-tax basis.

Termination of COBRA Continuation Coverage

COBRA coverage will end if:

  • You obtain coverage under another group plan
  • You fail to pay the premium required under the plan within the grace period
  • The applicable COBRA period ends

Covered California: Alternative to COBRA

If you are not eligible for SFHSS coverage, you should consider getting health insurance through the state exchange, Covered California. You may qualify for tax credits or other financial assistance to help make coverage more affordable.
For more information about Covered California health plans, call (800) 300-1506 or visit coveredca.com.

Did You Know?

Dependents dropped from coverage during Open Enrollment are not eligible for COBRA.

What to expect when making your COBRA election:


COBRA Icons

1. Your employer notifies P&A Group of your loss of coverage. 

2. A Qualifying Life Event Notice or QE Notice, which outlines your COBRA options, is mailed by P&A Group to your home via first class mail. You will receive your QE notice within 14 days of P&A receiving notification of your departure or life change event. 

3. The COBRA eligible employee or dependent reviews the material provided. If elected, this packet must be returned to P&A Group, along with the total invoice payment within the time frame stated on the notice. 

4. P&A Group contacts each insurance carrier to get your coverage(s) reinstated retroactively to the indicated effective date. 

5. P&A Group issues a customized COBRA invoice to the COBRA continuant. Payment can be made online or by mailing a check to the P&A Group. 
 

Easy Online Payments
You can make one-time payment or setup recurring payments online when you log into your P&A Account at www.padmin.com from your computer, tablet, or mobile device. 

P&A Group Customer Service 
Hours: Monday - Friday, 8:30 a.m. - 10:00 p.m. ET
Website: www.padmin.com 
Phone: (800) 688-2611