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Get the free COBRA Election Form AEF-Cobra2 11/05

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CENTRAL RESERVE LIFE INSURANCE COMPANY 17800 Royal ton Road ? Cleveland, OH 44136-5197 ? 440-572-2400 www.centralreserve.com COBRA ELECTION FORM DIRECTIONS: Employer and employees/dependents, please
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Cobra election form aef-cobra2 is a form used to elect COBRA continuation coverage for eligible individuals.
Qualified beneficiaries, such as employees or dependents, who wish to continue their health insurance coverage under COBRA must file the cobra election form aef-cobra2.
To fill out cobra election form aef-cobra2, qualified beneficiaries must provide their personal information, the specific COBRA coverage they want to elect, and any required payment details. The form should be completed accurately and submitted according to the instructions provided.
The purpose of cobra election form aef-cobra2 is to allow qualified beneficiaries to choose and enroll in COBRA continuation coverage after experiencing a qualifying event that would otherwise result in the loss of health insurance coverage.
Cobra election form aef-cobra2 typically requests information such as the beneficiary's name, contact details, the specific COBRA coverage being elected, and any necessary payment information.
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