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Continuation of Coverage * (COBRA or State Continuation) 1133 SW Topeka Boulevard Topeka, Kansas 666290001 www.bcbsks.com Section 1 Note: An Enrollment form (40127) of group coverage must be completed
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How to fill out continuation of coverage cobra

How to fill out continuation of coverage cobra
01
Gather all the necessary information and documents such as COBRA notice, COBRA election form, premium payment information, and proof of eligibility.
02
Read the COBRA notice carefully to understand your rights and responsibilities.
03
Fill out the COBRA election form accurately, providing all the required information.
04
Include the continuation of coverage COBRA premium payment for the desired coverage period.
05
Submit the completed COBRA election form and payment by the specified deadline.
06
Keep copies of all documents submitted for your records.
07
Maintain regular premium payments to avoid coverage interruptions.
Who needs continuation of coverage cobra?
01
Individuals who were covered under a group health plan and have experienced a qualifying event such as termination of employment, reduction of work hours, divorce, or death of the primary insured.
02
Dependents of the primary insured who were covered under a group health plan and have experienced a qualifying event.
03
Those who wish to continue their health insurance coverage for a limited period of time after the qualifying event.
04
People who want to maintain access to the same health benefits provided by their previous employer's group health plan.
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What is continuation of coverage cobra?
COBRA (Consolidated Omnibus Budget Reconciliation Act) allows employees to continue their employer-sponsored health coverage for a limited time after they would otherwise lose coverage.
Who is required to file continuation of coverage cobra?
Employers with 20 or more employees are required to offer COBRA continuation coverage.
How to fill out continuation of coverage cobra?
Employees can typically fill out COBRA forms provided by their employer or health insurance plan administrator.
What is the purpose of continuation of coverage cobra?
The purpose of COBRA is to give individuals the option to continue their health insurance coverage for a period of time after a qualifying event would normally result in loss of coverage.
What information must be reported on continuation of coverage cobra?
COBRA forms typically require information such as the employee's name, qualifying event, coverage options, and premium amounts.
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