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Continuation of Benefits January 1, 2017, to December 31, 2017, Employee Name: SS#: Employment Location: I understand that my medical, dental and vision insurance benefits cease upon the date of loss
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How to fill out continuation of benefits

01
Gather all necessary documentation such as employer information, termination letter, and proof of eligibility.
02
Contact your employer or human resources department to obtain the continuation of benefits application.
03
Complete the application form neatly and accurately, ensuring all required fields are filled out.
04
Attach the supporting documents to the application. This may include a copy of your termination letter or proof of qualifying event.
05
Submit the completed application and supporting documents to the appropriate department or mailing address.
06
Wait for confirmation of your application and continue paying any required premiums to maintain the benefits.
07
If approved, follow the instructions provided by the benefits provider to access and utilize the continued benefits.

Who needs continuation of benefits?

01
Individuals who have recently lost their job due to layoff, termination, or end of contract.
02
Employees whose employers offer a continuation of benefits program.
03
Those who depend on employer-provided benefits such as health insurance, retirement plans, or other financial support.
04
People who want to maintain their existing coverage and do not want a gap in their benefits.
05
Individuals who are eligible for continuation of benefits based on certain qualifying events as defined by the benefits program.
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Continuation of benefits refers to the process of extending certain benefits beyond their initial expiration date.
Employees or beneficiaries who are eligible to receive benefits that can be continued beyond the initial period.
Continuation of benefits can typically be filled out by submitting the required forms to the relevant department or administrator.
The purpose of continuation of benefits is to ensure that eligible individuals continue to receive the benefits they are entitled to.
Information such as the name of the beneficiary, the type of benefits being continued, and the reason for the continuation must be reported.
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