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CFRA Sample Policy - 50 or More Employees
Use this sample to create your policy that communicates any employee requirements and gives notice to your employee of their right to California Family Rights Act (CFRA) leave. Use this version if you have 50 or more employees.
CFRA Sample Policy - 50 or More Employees - Spanish
Use this sample to create your policy that communicates any employee requirements and gives notice to your employee of their right to California Family Rights Act (CFRA) leave. Use this version if you have 50 or more employees.
CFRA Sample Policy - Five to 49 Employees
Use this sample to create your policy that communicates any employee requirements and gives notice to your employee of their right to California Family Rights Act (CFRA) leave. Use this version if you have five to 49 employees.
CFRA Sample Policy - Five to 49 Employees - Spanish
Use this sample to create your policy that communicates any employee requirements and gives notice to your employee of their right to California Family Rights Act (CFRA) leave. Use this version if you have five to 49 employees.
CFRA/FMLA - Family Member Leave for a Qualifying Exigency
This chart describes the types of events that give an eligible employee a reason for leave because of a qualifying exigency under the CFRA/FMLA arising because the spouse, son or child of the employee is on covered active duty or call to active duty.
CFRA/FMLA - Family Member Leave for a Qualifying Exigency - Spanish
This chart describes the types of events that give an eligible employee a reason for leave because of a qualifying exigency under the CFRA/FMLA arising because the spouse, son or child of the employee is on covered active duty or call to active duty.
CHIP — Children's Health Insurance Program — Model Notice for Employers
If you are eligible for health coverage from your employer, but are unable to afford the premiums, some states have premium assistance programs that can help pay for coverage. These states use funds from their Medicaid or CHIP programs to help people who are eligible for employer-sponsored health coverage but need assistance in paying their health premiums.
CHIP — Children's Health Insurance Program — Model Notice for Employers — Spanish
If you are eligible for health coverage from your employer, but are unable to afford the premiums, some states have premium assistance programs that can help pay for coverage. These states use funds from their Medicaid or CHIP programs to help people who are eligible for employer-sponsored health coverage but need assistance in paying their health premiums.
CHIPRA Fact Sheet
The DOL has posted a model employer Children's Health Insurance Program (CHIP) Notice that can be used to satisfy the employer notice requirement under the Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA). CHIPRA added new notice and disclosure obligations for employers that provide group health plans in states that offer Medicaid or state CHIP assistance in the form of premium assistance subsidies. CHIPRA also created additional HIPAA special enrollment rights that permit eligible employees and their dependents to enroll in an employer's group health plan in two situations: (1) when Medicaid or CHIP coverage is terminated due to loss of eligibility; and (2) upon eligibility for a premium assistance subsidy under Medicaid or CHIP. The Employer CHIP Notice must be provided annually, on an automatic basis and free of charge. It must inform each employee (regardless of enrollment status) of potential opportunities for premium assistance in the state in which the employee resides.
COBRA Administration Guide
Begin using this COBRA Administration Guide when an employee is hired and refer back to it when a qualifying event occurs. Doing so ensures you use the proper, required forms relating to COBRA (20 or more employees) and Cal-COBRA (2 to 19 employees), as applicable.
COBRA Continuation Coverage Election Notice — California Employees
Modify this form according to the coverage plans that you offer and send it out with all COBRA notices. The employee is required to fill out and return the form to the plan administrator within 60 days of a qualifying event or the date they were notified of COBRA continuation rights.
COBRA Continuation Coverage Election Notice — California Employees — Spanish
Modify this form according to the coverage plans that you offer and send it out with all COBRA notices. The employee is required to fill out and return the form to the plan administrator within 60 days of a qualifying event or the date they were notified of COBRA continuation rights.
COBRA Continuation Coverage Election Notice — Outside California
Modify this form according to the coverage plans that you offer and send it out with all COBRA notices. The employee is required to fill out and return the form to the plan administrator within 60 days of a qualifying event or the date they were notified of COBRA continuation rights.
COBRA Continuation Coverage Election Notice — Outside California — Spanish
Modify this form according to the coverage plans that you offer and send it out with all COBRA notices. The employee is required to fill out and return the form to the plan administrator within 60 days of a qualifying event or the date they were notified of COBRA continuation rights.
COBRA Continuation Coverage Rights General Notice — California Employees
Provide this form to an employee or spouse within 90 days of the commencement of coverage or the first date at which the plan administrator is required to advise a qualified beneficiary of the right to elect coverage.