Get the free Assurant Dental COBRA Election Form

Request To Elect Dental COBRA * Required Field EMPLOYER SECTION NOTE: The Federal Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) requires employers to notify qualified individuals

How to fill out assurant dental cobra election

How to fill out Assurant Dental COBRA election:

1. Visit the Assurant Dental website or go to the employer's COBRA administration portal.
2. Look for the option to elect COBRA continuation coverage and click on it.
3. Enter the required information such as your name, address, contact details, and Social Security number.
4. Provide your qualifying event details, which led to the loss of your previous dental coverage.
5. Choose the dental plan you wish to continue and select the effective date for the coverage.
6. Review the terms and conditions of the Assurant Dental COBRA continuation coverage.
7. Pay the required premium for the coverage period. The premium is usually higher than what you paid as an active employee.
8. Submit the completed Assurant Dental COBRA election form and make sure to retain a copy for your records.

Who needs Assurant Dental COBRA election:

1. Individuals who have recently lost their dental coverage due to a qualifying event, such as termination of employment, reduction in work hours, or divorce from the covered employee.
2. Dependents of employees who had dental coverage but are no longer eligible due to the employee's death or eligibility change.
3. Individuals who wish to continue dental coverage for a specific period of time after the loss of their previous coverage.

For pdfFiller’s FAQs

What is assurant dental cobra election?

Assurant dental COBRA election is the process by which eligible individuals can elect to continue their dental coverage under the Consolidated Omnibus Budget Reconciliation Act (COBRA) after experiencing a qualifying event.

Who is required to file assurant dental cobra election?

Employees or their eligible dependents who lose dental coverage due to a qualifying event are required to file Assurant dental COBRA election.

How to fill out assurant dental cobra election?

To fill out Assurant dental COBRA election, eligible individuals must complete the necessary forms provided by Assurant or their employer, indicating their decision to continue dental coverage under COBRA.

What is the purpose of assurant dental cobra election?

The purpose of Assurant dental COBRA election is to provide individuals with the option to maintain dental coverage for a limited period after losing their eligibility for group dental insurance.

What information must be reported on assurant dental cobra election?

Assurant dental COBRA election forms typically require personal information such as the individual's name, contact details, the qualifying event that resulted in loss of coverage, and the election to continue coverage under COBRA.

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