When a job ends, one of the first worries is often health insurance. This article explains, in general terms, how federal COBRA continuation coverage works and what other options people often look at. It is general information, not advice about your plan or your situation.

What COBRA is

COBRA is a federal law that can let you, and family members on your plan, stay on your former employer's group health plan for a while after your job ends. You keep the same plan, but you usually pay for it yourself.

COBRA generally applies to group health plans of employers that had at least 20 employees on more than half of their typical business days in the previous calendar year. Both full-time and part-time workers count toward that number, with part-time workers counted as a fraction of a full-time worker (DOL Worker's Guide to COBRA).

Many states also have their own "mini-COBRA" laws that may cover employers with fewer than 20 employees (DOL Worker's Guide to COBRA). California has its own rules, so plans at smaller employers may be handled differently. If you worked for a smaller employer, read the notice your plan or insurer sends, and ask them which rules apply to you.

What can trigger COBRA

For a worker, losing a job for any reason other than gross misconduct, or having work hours cut, can trigger COBRA. Spouses and children on the plan may also qualify after other events. These include divorce or legal separation, the worker's death, or a child losing dependent status (DOL Worker's Guide to COBRA).

This means COBRA is not only for people who quit or were laid off. A person who was fired can generally still be offered COBRA unless the firing was for gross misconduct. If your job ended in a way that felt unfair, our wrongful termination guide explains the general rules in California.

Deadlines to choose and pay

COBRA has a few dates that matter. Missing one can mean losing the chance to keep the plan, so it helps to mark them on a calendar as soon as your notice arrives.

You generally have at least 60 days to choose COBRA. The window starts on the later of two dates: the day you get the election notice, or the day your coverage would end (DOL COBRA continuation coverage). After you choose COBRA, plans must give you at least 45 days to make your first payment (DOL elaws Health Benefits Advisor).

How long coverage can last

After a job loss or a cut in hours, COBRA coverage usually lasts up to 18 months. It may reach 29 months with a disability extension. That extension can apply when Social Security finds you disabled before the 60th day of COBRA coverage. Certain family events, like a divorce or the worker's death, may allow up to 36 months (DOL Worker's Guide to COBRA). If you are dealing with a health condition, our medical leave guide covers your rights while you are still employed.

What COBRA can cost

COBRA is often more expensive than what you paid while working. That is because your former employer usually stops paying its share. You usually pay the full premium yourself, unless your employer agrees to cover some or all of it (DOL COBRA continuation coverage).

These caps come from the DOL Worker's Guide to COBRA and the DOL elaws Health Benefits Advisor. If you were offered severance, it can help to check whether the offer says anything about health coverage. Our severance review guide explains what to look for in general terms.

Other options to compare

COBRA is not the only path. Losing job-based coverage can open other doors, but each one has its own short window.

Two common choices after losing job-based coverage

COBRA

  • Keep the same plan and doctors
  • Generally at least 60 days to choose
  • You usually pay the full premium
  • Usually up to 18 months after a job loss

Other coverage

  • A family member's job plan: you usually have only 30 days to ask
  • Health Insurance Marketplace: generally 60 days to pick a plan
  • Plans, costs and doctors may be different
  • Compare the total cost before you decide

Both of those windows come from the DOL Worker's Guide to COBRA. In California, the Employment Development Department lists COBRA, Covered California, BenefitsCal (for Medi-Cal) and the County Medical Services Program as health resources (EDD Additional Resources). Each program sets its own rules, so check with them directly.

Money is often tight after a job ends. California unemployment benefits pay $40 to $450 a week, depending on how much you earned in the past 18 months (EDD Unemployment).

Where to get official help

  • U.S. Department of Labor benefits advisors: call 1-866-444-3272 with questions about federal COBRA (DOL COBRA continuation coverage).
  • Health Insurance Marketplace: call 1-800-318-2596 (DOL Worker's Guide to COBRA).
  • Your plan or insurer: the notice they send should list your deadlines, costs and which rules apply. If you worked for a smaller employer, ask them about California's continuation rules.