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Benefits Continuation While on Approved Unpaid Leave of Absence Maricopa County Employee Benefits Division Rev. 12/14/161Agenda Objective Policy Procedures Notification Process Termination of Benefits
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How to fill out benefits continuation

01
Step 1: Obtain the benefits continuation form from your employer or human resources department.
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Step 2: Read the instructions on the form carefully to understand the requirements and eligibility criteria.
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Step 3: Gather necessary documents such as proof of qualifying event, birth/adoption certificates, marriage/divorce certificates, etc.
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Step 4: Complete the required sections of the benefits continuation form accurately and legibly.
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Step 5: Attach all the supporting documents along with the completed form.
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Step 6: Review the form to ensure all information is correct and nothing is missing.
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Step 7: Submit the benefits continuation form and supporting documents to your employer or human resources department.
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Step 8: Keep a copy of the submitted form and documents for your records.
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Step 9: Follow up with your employer or human resources department to ensure the form is processed and benefits continuation is in effect.
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Step 10: If you have any questions or need assistance, contact the appropriate department for guidance.

Who needs benefits continuation?

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Employees who experience a qualifying event such as job loss, retirement, reduction in work hours, change in marital status, birth/adoption of a child, or divorce may need benefits continuation.
02
Individuals who want to continue their health, dental, vision, life insurance, or other employee benefits after leaving their job or experiencing a qualifying event require benefits continuation.
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Those who need time to search for new employment or explore alternative healthcare options while maintaining coverage may also benefit from benefits continuation.
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Spouses and dependents of employees who are covered under the employer's benefits plan and face a qualifying event may also be eligible for benefits continuation.
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It is advisable to review your specific employment situation and consult with your employer or human resources department to determine if you are eligible for benefits continuation.
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Benefits continuation is the process of maintaining certain benefits, such as health insurance, after a qualifying event that would normally result in their termination, such as job loss or a reduction in work hours.
Employees who experience a qualifying event that would normally result in the termination of their benefits are required to file for benefits continuation.
To fill out benefits continuation, employees typically need to complete a form provided by their employer or benefits administrator, providing information about the qualifying event and indicating their desire to continue receiving benefits.
The purpose of benefits continuation is to provide individuals with the opportunity to maintain certain benefits that they would otherwise lose due to a qualifying event, such as job loss or a reduction in work hours.
Information such as the qualifying event, the benefits to be continued, and the duration of the continuation must be reported on benefits continuation.
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