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Date EMPLOYEE NAME EMPLOYEE ADDRESS Dear EMPLOYEE NAME :In accordance with North Carolina state continuation law, you are eligible to continue your health plan for you and any eligible dependents
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How to fill out state continuation of health

01
To fill out state continuation of health, follow these steps:
02
Obtain the necessary forms from your employer or insurance company.
03
Fill in your personal information, such as name, address, and contact details.
04
Provide information about your previous health coverage.
05
Indicate why you are eligible for state continuation of health (e.g., job loss, divorce, or reduction in work hours).
06
Specify the length of time you need continued coverage.
07
Sign and date the form.
08
Submit the completed form to your employer or insurance company as instructed.

Who needs state continuation of health?

01
State continuation of health is needed by individuals who experience a qualifying event that causes the loss or reduction of health coverage provided by their employer. Qualifying events may include loss of job, divorce, reduction in work hours, or other circumstances that terminate existing health coverage. This option allows individuals to continue their health coverage for a limited period of time, typically 18 to 36 months, by paying the premium themselves.

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State continuation of health is a provision that allows individuals to continue their health insurance coverage after experiencing a qualifying event, similar to COBRA, but typically offering extended access for certain groups or under specific state laws.
Employers providing group health insurance coverage are required to file state continuation of health for eligible employees and their dependents when a qualifying event occurs.
To fill out state continuation of health, the eligible individual must complete the required application or notification form provided by the employer or health insurance provider, ensuring all necessary personal and coverage information is accurately included.
The purpose of state continuation of health is to provide a safety net for individuals who have lost their health insurance coverage due to specific circumstances, allowing them to maintain their health benefits for a limited period.
Information that must be reported typically includes the individual's name, contact details, employment information, details of the qualifying event, and any other relevant health coverage details as required by state law.
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