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P.O. Box 91059 Seattle, WA 98111-9159 COBRA CONTINUED GROUP COVERAGE APPLICATION To continue coverage under your group health care program, you will need to complete this form and return it to your

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What is cobra application - instant?

A Cobra application is a form that individuals must fill out to apply for continued health coverage through the Consolidated Omnibus Budget Reconciliation Act (COBRA) program. It allows eligible individuals to maintain their health insurance coverage after a qualifying event such as job loss or reduction in work hours.

Who is required to file cobra application - instant?

Individuals who experience a qualifying event that results in the loss of their employer-sponsored health insurance are required to file a COBRA application. This includes employees, their spouses, and dependent children.

How to fill out cobra application - instant?

To fill out a COBRA application, individuals need to provide personal information such as their name, address, and contact details. They may also need to include information about their qualifying event and the employer-sponsored health plan they were previously enrolled in.

What is the purpose of cobra application - instant?

The purpose of a COBRA application is to initiate the process of continuing health insurance coverage under the COBRA program. It allows eligible individuals to maintain the same level of health insurance coverage they had while they were employed, even if they no longer work for the employer offering the plan.

What information must be reported on cobra application - instant?

A COBRA application typically requires individuals to provide personal information such as their name, address, date of birth, and Social Security number. They may also need to provide information about their previous employer, the qualifying event, and the health insurance plan they were enrolled in.

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