Written by a parent, not a doctor. Nothing here is medical advice.

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California program

Keep a small-employer health plan (Cal-COBRA)

A way to keep an eligible fully insured work health plan after it would otherwise end, with you paying the premium.

What it is

A way to keep an eligible fully insured work health plan after it would otherwise end, with you paying the premium.

Keeping the same plan may help your child stay with the same treatment team after a job change. The premium can be expensive once you pay it yourself. A comparison with Medi-Cal and Covered California needs to include both cost and access to care.

Who can get it
  • The small-employer route covers fully insured plans at employers with 2 to 19 eligible employees.
  • Self-funded plans, dental and vision are excluded. An extension after federal COBRA depends on qualifying coverage.
  • The disability extension can cost up to 150% of the group premium after the first 18 months.
What you get
  • Up to 36 months of continued coverage, usually at up to 110% of the group premium.
  • For eligible federal COBRA members, an extension to 36 months total.
If you decide to apply
  1. Ask the health plan for the Cal-COBRA notice, premium and deadlines when a qualifying event would end coverage.
  2. Have ready: the plan card, last day of employment and employer headcount.

The health plan · Official page ↗

What happens next
  • The employer has 30 days to notify the plan, which has 14 days after that to send the election notice.
  • The first premium covers the period since the prior coverage ended. Written confirmation identifies continuation and the required premium.
Good to know

The election period is 60 days from the later of coverage ending or the notice. The first payment is due within 45 days after election.

What else to know
  • Covered California has its own loss-of-coverage enrollment period, generally 60 days. The same doctors are not guaranteed under a different plan.
  • A larger employer may use federal COBRA instead. The employer and plan documents identify the applicable route.
Official sources
Ask your social worker

“If work coverage ends, could Cal-COBRA keep our child with the same team? What would it cost compared with other plans, and could you help us review the notice before we choose?”

Why I’m asking: I want to understand the cost and deadlines for keeping the same health plan if work coverage ends.

More background and detailed requirements
Additional program information and published rules

Who does what

The three parts, side by side. The agency decides; nobody on this page does.

You

Ask the plan for the Cal-COBRA letter when employment ends and sign up by the printed deadline if you keep the plan.

Your social worker

The social worker can check whether the oncology team is in any Covered California or Medi-Cal plan you are comparing against.

The care team

Records and letters when the application asks for them.

Who decides
The health plan (the insurer on the card)
Ask HR
“If I leave, is our plan fully insured, and will the insurer send the Cal-COBRA letter so my child's coverage continues without a gap?”

How to apply

First step: Ask the health plan (the number on the card) for the Cal-COBRA letter when employment ends, and note the election deadline it prints.

  1. Ask the plan for the Cal-COBRA election notice the day the job ends.
  2. Compare with Covered California and Medi-Cal before electing.

Where it starts: Cal-COBRA letter from the plan when employment ends

What to gather

  • The plan card
  • The last day of employment
  • The employer's headcount

How long: The employer tells the plan within 30 days; the plan sends the notice within 14 days. Elect within 60 days, pay within 45 days of electing.

Clock: elect Cal-COBRA in writing within 60 days of the later of the coverage end or the notice

Clock: pay the first premium (all months since coverage ended) within 45 days of electing

What a yes looks like

Confirmation that the same plan continues with no gap, at the stated premium.

What a no looks like, and the next move

A letter saying the plan is self-funded or the employer too large. Then it is federal COBRA (20+) or Covered California within 60 days.

Watch out

  • You pay up to 110% of the group premium. Compare with Covered California in its 60-day period and with Medi-Cal for the child before choosing.
  • Clocks: the employer tells the plan within 30 days, the plan sends the election notice within 14 days of that. You have 60 days from the later of the coverage end or the notice to elect, then 45 days to pay the first premium, which covers the months since coverage ended.
  • Vision and dental plans are excluded.
  • Only fully insured plans. A self-funded employer plan is not covered by Cal-COBRA.

The numbers and the rules

The arcane layer, kept on purpose. Checked September 8, 2026.

What it is worth

Continuation of the same plan for up to 36 months at up to 110% of the group rate. Federal COBRA enrollees are extended to 36 months total.

  • $36 — Maximum continuation
  • $110 — Premium cap
  • $150 — Premium cap after the first 18 months in the disability extension

Legal protection: Continuation of a fully insured group plan from an employer with 2 to 19 eligible employees · Extension to 36 months total after federal COBRA · Premium capped at 110% of the group rate (150% after 18 months in the disability extension) · Election within 60 days of the later of the coverage end or the notice; first premium within 45 days of electing

What it costs the family: Up to 110% of the group rate. Up to 150% after the first 18 months in the disability extension.

The eligibility facts, as published

Employer size
2 to 19 eligible employees (or federal COBRA exhausted)
Plan type
fully insured only
Excluded
self-funded plans; vision and dental

Decisions this site cannot make: Qualifying event notice from the plan

Expect friction on: Election deadline printed on the notice · Full premium

The trap: You pay the premium. Compare with Covered California in its 60-day period and with Medi-Cal for the child before choosing.

Where I read this

← Back to your options