Get the free Continuation of Benefits Enrollment Form

This form is for students insured under the 2009-10 University of Vermont Student Accident and Sickness Insurance Plan to enroll for continued coverage after their eligibility ends.

How to fill out continuation of benefits enrollment

How to fill out Continuation of Benefits Enrollment Form

1. Obtain the Continuation of Benefits Enrollment Form from your HR department or the benefits administrator.
2. Read the instructions carefully to ensure you understand the requirements.
3. Fill out your personal information, including name, address, and contact details at the top of the form.
4. Indicate the type of benefits you wish to continue, such as health insurance or other applicable benefits.
5. Provide any additional necessary documentation that supports your eligibility for continuation of benefits.
6. Review the completed form for accuracy and completeness.
7. Sign and date the form where indicated.
8. Submit the form to the appropriate department or individual as specified in the instructions.

Who needs Continuation of Benefits Enrollment Form?

1. Employees who have experienced qualifying events such as job loss, reduction in hours, or leave of absence.
2. Dependents of employees who may be eligible for continued benefits.
3. Individuals who want to retain their benefits despite changes in employment status.

People Also Ask about

What is benefit of continuation?

Benefit Continuation means the continued participation for Executive and her eligible dependents in the Company Group's medical and dental benefit plans, via an effective election by Executive under COBRA.

What is benefit continuation?

In general, COBRA is expensive because you pay both your employee side of premiums AND the employer side of premiums. For example, this could be a total of like $600 for a single person that's young.

What is the coverage continuation benefit?

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.

What is the 60 day loophole for cobras?

Benefit Continuation means the continued participation for Executive and her eligible dependents in the Company Group's medical and dental benefit plans, via an effective election by Executive under COBRA.

What is a benefits enrollment form?

Benefits enrollment, also known as open enrollment or benefits election, refers to the process through which employees choose and sign up for the employee benefits offered by their employer. These benefits often include health insurance, dental insurance, vision insurance, life insurance, retirement plans, and similar.

What is the meaning of continuation of benefits?

Continuation of Benefits means the continuation of all benefits (to the extent permissible under the terms and conditions of each applicable employee benefit program and applicable law) in which you participate as of the date of the Qualifying Event for the term of the Severance Period, provided that you continue to

What is continued benefits?

If you are not on automatic payment, you will receive a Claim for Continued Disability Benefits (DE 2500A) every two weeks to certify that your disability continues. Your benefits will stop if you do not complete and return the DE 2500A.

For pdfFiller’s FAQs

What is Continuation of Benefits Enrollment Form?

The Continuation of Benefits Enrollment Form is a document that allows individuals to maintain their health insurance coverage after leaving employment or experiencing another qualifying event that typically results in the loss of insurance benefits.

Who is required to file Continuation of Benefits Enrollment Form?

Individuals who have experienced a qualifying event such as job loss, reduction in work hours, or other life events that impact their health insurance coverage are required to file the Continuation of Benefits Enrollment Form.

How to fill out Continuation of Benefits Enrollment Form?

To fill out the Continuation of Benefits Enrollment Form, individuals should provide their personal information, including name, address, and social security number, describe the qualifying event, and indicate the benefits they wish to continue. Ensure to follow any specific instructions provided with the form.

What is the purpose of Continuation of Benefits Enrollment Form?

The purpose of the Continuation of Benefits Enrollment Form is to enable eligible individuals to continue receiving health insurance coverage under their employer’s plan, ensuring they have access to necessary medical services after a qualifying event.

What information must be reported on Continuation of Benefits Enrollment Form?

The information that must be reported includes the individual’s personal details (name, address, contact information), details of the qualifying event (date and type of event), and any specific benefits or plans the individual wishes to continue.