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1 CONTINUATION COVERAGE GROUP PERS USE ONLY: DOCUMENT REFERENCE NUMBER California Public Employees Retirement System Health Account Services P.O. Box 942715 Sacramento, CA 94229-2715 888 CalPERS (or.

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Related content

State Health Benefits Guide - CalPERS - CA.gov
PERS-HBD-85 COBRA Election Form (PDF). To continue coverage under. COBRA provisions and...
Learn more
COBRA Election Form - HR Landing Page
Health Account Services. P.O. Box 942715. Sacramento, CA 94229-2715. 888 CalPERS (or...
Learn more

Related links form

SOLID WASTE DISPOSAL REPORT - Nevada Division Of - Ndep Nv WASHOE CO DEPT OF WATER RESOURCES - Ndep Nv SPRING CREEK UTILITIES COMPANY - Ndep Nv FACTSHEET - Nevada Division Of Environmental Protection - Ndep Nv

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All employers are responsible for administering their own federal COBRA program. Blue Shield administers Cal-COBRA when an employer is subject to it under state law.

Cal-COBRA administration may be handled by either the employer or a third-party administrator, but as the legal obligation still falls to the employer to comply with the law, all employers should make sure these administrative steps are being completed and done so in a timely manner.

If you elect to receive COBRA benefits, you will pay 100% of the total premium for your benefits plus a 2% administrative fee.

Employers are responsible for notifying their Cal-COBRA members of the transition to a new carrier and Cal-COBRA members are required to fill out the form and submit it to the Cal-COBRA team within 30 days of transition. Information on COBRA subsidies from the 2021 American Rescue Plan Act is available here.

The COBRA statute requires that continuation coverage be offered to covered employees and their covered dependents in order to continue their State-sponsored health/dental/vision benefit(s) in the event coverage is lost due to certain qualifying events.

Federal COBRA generally extends health coverage for 18 months. Individuals with certain qualifying events may be eligible for a longer extension (e.g., 29 or 36 months). Cal-COBRA allows individuals to continue their group health coverage for up to 36 months.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232