Get the free CalCobra Information RequestContinuation Election Form

Calibra Information Request/Continuation Election Form American General Life Insurance Company *of Delaware* Wilmington, Houston, Texas Delaware Administrative Office: PO Box 30066, Tampa, FL 336303066

How to fill out calcobra information requestcontinuation election

How to fill out calcobra information requestcontinuation election:

1. Obtain the calcobra information requestcontinuation election form from your employer or health insurance provider. It may also be available online on their website.
2. Start by providing your personal information, such as your name, address, and contact details.
3. Specify the reason for requesting the continuation of calcobra coverage - this could be due to a job loss, reduction in work hours, or eligibility for Medicare.
4. Indicate the type of calcobra coverage you wish to continue, whether it's medical, dental, vision, or a combination.
5. If applicable, provide the details of your dependents who are also seeking calcobra continuation coverage.
6. Calculate the duration of coverage you are requesting. This is typically up to 18 months but may vary based on your specific circumstances.
7. Sign and date the form, certifying the accuracy of the information provided.
8. Submit the completed form to your employer or health insurance provider by the specified deadline. Keep a copy for your records.

Who needs calcobra information requestcontinuation election:

1. Employees who have recently lost their job and want to continue their health insurance coverage.
2. Individuals facing a reduction in work hours that make them ineligible for their employer's group health insurance plan.
3. Individuals who become eligible for Medicare and want to retain their calcobra coverage until their Medicare benefits kick in.
4. Employees who are going through a divorce or separation and need to secure their own health insurance coverage outside of their former spouse's plan.
5. Dependents who were covered under an employee's health insurance plan and want to continue their coverage after the employee's loss of job, reduction in work hours, or Medicare eligibility.

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What is calcobra information requestcontinuation election?

The calcobra information requestcontinuation election is a form that allows eligible individuals to continue their COBRA coverage after their original COBRA coverage period ends.

Who is required to file calcobra information requestcontinuation election?

Individuals who wish to continue their COBRA coverage beyond the initial coverage period are required to file the calcobra information requestcontinuation election.

How to fill out calcobra information requestcontinuation election?

To fill out the calcobra information requestcontinuation election, individuals must provide their personal information, COBRA continuation coverage details, and election decision.

What is the purpose of calcobra information requestcontinuation election?

The purpose of the calcobra information requestcontinuation election is to give individuals the opportunity to extend their COBRA coverage beyond the initial period.

What information must be reported on calcobra information requestcontinuation election?

The calcobra information requestcontinuation election form typically requires information such as personal details, current COBRA coverage information, and election decision.