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How soon after employing a 20th employee must an employer transition to (federal) COBRA from Cal-COBRA?

California employers must offer Cal-COBRA continuation coverage to qualified beneficiaries if the business employed 2-19 employees on more than 50% of working days during the previous calendar year. Cal-Cobra is administered by the insurance carrier for fully-insured plans.

Likewise, all employers must offer COBRA continuation coverage (often referred to as “federal COBRA”) to qualified beneficiaries if the business employed more than 19 employees on more than 50% of working days during the previous calendar year. The employer must administer COBRA, though many engage a firm that specializes in COBRA administration to do so.

Much like the ACA’s Applicable Large Employer (ALE) determination, COBRA uses a look-back to determine if the employer must offer COBRA, Cal-COBRA or no COBRA. It can be summed up as: “your employee count last year determines your COBRA status for next year.” Today’s question relates to a business that has just brought on their 20th employee. At what time do they transition to COBRA from Cal-COBRA? As with many things, the answer depends…

For example, on January 1, 2018, the employer will look back at the composition of their workforce during 2017 and if that 20th employee caused them to have 20 or more employees on more than 50% of working days during 2017, then they will transition to COBRA from Cal-COBRA on January 1, 2018, for the entirety of 2018.

If however, that 20th employee was added in December 2017 for example, then it’s likely the business did not have 20 or more employees on more than 50% of working days during 2017 and when the employer does the look-back analysis on January 1, 2018 they will conclude that Cal-COBRA is the appropriate continuation coverage to offer.

Employers who determine in early January that their COBRA status has changed based on the look back analysis should immediately report that change to the carrier. The carrier will then either start or stop administering Cal-COBRA as determined by the employer’s report. Keep in mind that an employer’s COBRA status is determined early in January every year and is not tied to the employer’s plan year.

Department of Labor – “An Employer’s Guide to…COBRA” is an excellent reference for brokers and employers.

Willis: This in-depth Q & A regarding COBRA continuation coverage is very helpful. See question #16 for a discussion of when an employer must offer COBRA.