Get the free COBRA Form 11 (IB11) - Alabama State Employees' Insurance Board
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IB11 Revised 8/12 COBRA Employer Notice Memo Or Send a copy of Form 11 Name of Employee Number and Street or P. O. Box Social Security Number City State Zips The above identified employee of is covered
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What is cobra form 11 ib11?
Cobra Form 11 IB11 is a federal form used to report certain information about an individual's continued health insurance coverage.
Who is required to file cobra form 11 ib11?
Employers or plan administrators who provide COBRA continuation coverage must file Cobra Form 11 IB11.
How to fill out cobra form 11 ib11?
To fill out Cobra Form 11 IB11, you need to provide information such as the individual's name, social security number, and details about the continuation coverage.
What is the purpose of cobra form 11 ib11?
The purpose of Cobra Form 11 IB11 is to report information about an individual's continuation coverage for compliance and record-keeping purposes.
What information must be reported on cobra form 11 ib11?
Cobra Form 11 IB11 requires reporting of the individual's name, social security number, dates of coverage, and certain other details related to the COBRA continuation coverage.
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