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BROWN COUNTY GREEN BAY WI Health Benefit Summary Plan Description 767004010143 Revised 01012016BENEFITS ADMINISTERED Notable of Contents INTRODUCTION ...........................................................................................................................................
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How to fill out cobra continuation of coverage

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How to fill out cobra continuation of coverage

01
Obtain the COBRA election notice from your employer or health plan administrator.
02
Review the notice carefully to understand your rights and obligations.
03
Determine if you are eligible for COBRA continuation of coverage.
04
Complete the enrollment form included with the notice, providing all required information.
05
Choose the coverage options that best suit your needs.
06
Submit the completed enrollment form within the specified timeframe.
07
Pay the initial premium within the designated deadline to activate your COBRA coverage.
08
Continue to pay your monthly premiums on time to maintain continuous coverage.
09
Understand the duration of COBRA coverage and plan accordingly for future coverage options.
10
Notify your employer or health plan administrator if any changes occur that may affect your eligibility or coverage.

Who needs cobra continuation of coverage?

01
Individuals who lose their job or experience a reduction in work hours and were previously covered under an employer-sponsored health insurance plan.
02
Spouses and dependent children of employees who lose coverage due to the employee's job loss or reduction in work hours.
03
Those who have been covered under a group health plan but are no longer eligible for coverage (e.g., due to divorce or aging out of dependent status).
04
Individuals who want to continue their health insurance coverage when faced with certain qualifying events, such as the death of the covered employee.
05
People who have exhausted their other health coverage options and need a temporary solution to maintain insurance.
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COBRA continuation of coverage allows employees who lose their job to continue their health insurance for a limited time.
Employers with at least 20 employees are required to offer COBRA continuation of coverage.
Employees can fill out COBRA continuation of coverage forms provided by their employer or benefits administrator.
The purpose of COBRA continuation of coverage is to provide temporary health insurance coverage to individuals who have lost their job.
COBRA continuation of coverage forms typically include information such as the employee's name, social security number, and details of the health insurance plan.
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