Form preview

Get the free Temporary Continuation of Coverage (TCC) Program Notice - state

Get Form
This document provides guidance on the Federal Employee Health Benefit (FEHB) Temporary Continuation of Coverage (TCC) program for separating employees and certain dependents who lose regular FEHB
We are not affiliated with any brand or entity on this form

Get, Create, Make and Sign temporary continuation of coverage

Edit
Edit your temporary continuation of coverage form online
Type text, complete fillable fields, insert images, highlight or blackout data for discretion, add comments, and more.
Add
Add your legally-binding signature
Draw or type your signature, upload a signature image, or capture it with your digital camera.
Share
Share your form instantly
Email, fax, or share your temporary continuation of coverage form via URL. You can also download, print, or export forms to your preferred cloud storage service.

How to edit temporary continuation of coverage online

9.5
Ease of Setup
pdfFiller User Ratings on G2
9.0
Ease of Use
pdfFiller User Ratings on G2
In order to make advantage of the professional PDF editor, follow these steps:
1
Create an account. Begin by choosing Start Free Trial and, if you are a new user, establish a profile.
2
Upload a file. Select Add New on your Dashboard and upload a file from your device or import it from the cloud, online, or internal mail. Then click Edit.
3
Edit temporary continuation of coverage. Rearrange and rotate pages, add and edit text, and use additional tools. To save changes and return to your Dashboard, click Done. The Documents tab allows you to merge, divide, lock, or unlock files.
4
Save your file. Select it in the list of your records. Then, move the cursor to the right toolbar and choose one of the available exporting methods: save it in multiple formats, download it as a PDF, send it by email, or store it in the cloud.
It's easier to work with documents with pdfFiller than you could have believed. You may try it out for yourself by signing up for an account.

Uncompromising security for your PDF editing and eSignature needs

Your private information is safe with pdfFiller. We employ end-to-end encryption, secure cloud storage, and advanced access control to protect your documents and maintain regulatory compliance.
GDPR
AICPA SOC 2
PCI
HIPAA
CCPA
FDA

How to fill out temporary continuation of coverage

Illustration

How to fill out Temporary Continuation of Coverage (TCC) Program Notice

01
Obtain the Temporary Continuation of Coverage (TCC) Program Notice from your employer or the plan administrator.
02
Read through the notice carefully to understand your eligibility for continuation of coverage.
03
Fill out your personal information, including your name, address, and contact details.
04
Provide information about your current coverage and qualifying event that triggers TCC eligibility.
05
Select the type of coverage you wish to continue and the duration for which you need it.
06
Review any costs associated with the continuation of coverage and how payment should be made.
07
Sign and date the form to confirm your request for continuation of coverage.
08
Submit the completed TCC form to your employer or the designated plan administrator within the required timeframe.

Who needs Temporary Continuation of Coverage (TCC) Program Notice?

01
Employees who experience a qualifying event that affects their health insurance coverage, such as job loss, reduction in hours, divorce, or death of a covered spouse.
02
Dependents who are covered under a parent's or spouse's health plan and need to continue their coverage after a qualifying event.
Fill form : Try Risk Free
Users Most Likely To Recommend - Summer 2025
Grid Leader in Small-Business - Summer 2025
High Performer - Summer 2025
Regional Leader - Summer 2025
Easiest To Do Business With - Summer 2025
Best Meets Requirements- Summer 2025
Rate the form
4.0
Satisfied
27 Votes

People Also Ask about

Temporary Continuation of Coverage (TCC) allows former employees to continue their health care coverage for up to 18 months and eligible family members to continue their health care coverage for up to 36 months.
TCC is a feature of the Federal Employees Health Benefits (FEHB) Program that allows certain people to temporarily continue their FEHB coverage after regular coverage ends. * Am I eligible to enroll? Federal employees and family members who lose their FEHB coverage because of a qualifying event may be eligible for TCC.
COBRA generally requires that group health plans sponsored by employers with 20 or more employees in the prior year offer employees and their families the opportunity for a temporary extension of health coverage (called continuation coverage) in certain instances where coverage under the plan would otherwise end.
Separating employees can continue TCC for up to 18 months after the date of separation. Children and former spouses can continue TCC for up to 36 months after: the date of the qualifying event when the child or former spouse is covered as a family member of an employee or annuitant under a regular FEHB enrollment, or.
TCCs for transmitting e-filed tax returns do not typically have a set expiration date, but they can become inactive if not used for an extended period. The IRS may deactivate a TCC if it has not been used for filing within the last two consecutive tax years.
What is the main difference between COBRA and TCC? COBRA applies to private-sector employees and some state/local government workers, while Temporary Continuation of Coverage (TCC) is exclusively for federal employees and their dependents under the Federal Employees Health Benefits (FEHB) Program.
Continuation coverage allows someone who recently lost their employer-based health coverage to continue their current insurance policy as long as they pay the full monthly premiums. Continuation coverage falls into four categories: COBRA, Cal-COBRA, Conversion, and HIPAA.

For pdfFiller’s FAQs

Below is a list of the most common customer questions. If you can’t find an answer to your question, please don’t hesitate to reach out to us.

The Temporary Continuation of Coverage (TCC) Program Notice is a notification that provides information about the option for individuals to continue their health insurance coverage after it has otherwise ended, typically due to job loss or other qualifying events.
Employers and group health plans that are subject to the TCC provisions must file the Temporary Continuation of Coverage (TCC) Program Notice to inform eligible individuals of their rights to continue health coverage.
To fill out the TCC Program Notice, you must include details such as the employer's name and contact information, the plan type, eligibility criteria, coverage options available, and the procedure to enroll in the continuation coverage.
The purpose of the TCC Program Notice is to ensure that individuals are informed of their rights to continue health insurance coverage after a qualifying event, thus providing a safety net during transitions between employment.
The TCC Program Notice must report the individual's right to continuation coverage, the eligibility requirements, the duration of coverage, premium amounts, deadlines for enrollment, and any relevant procedures for maintaining or reinstating coverage.
Fill out your temporary continuation of coverage online with pdfFiller!

pdfFiller is an end-to-end solution for managing, creating, and editing documents and forms in the cloud. Save time and hassle by preparing your tax forms online.

Get started now
Form preview
If you believe that this page should be taken down, please follow our DMCA take down process here .
This form may include fields for payment information. Data entered in these fields is not covered by PCI DSS compliance.