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CONTINUATION OF GROUP HEALTH COVERAGE NOTICE *VERY IMPORTANT NOTICE* To: Employee, Spouse and Dependent Children A federal law (Public Law 99272, Title X) known as COBRA (Consolidated Omnibus Budget

How to fill out continuation of group health

How to fill out continuation of group health:

1. Obtain the necessary form: The first step in filling out the continuation of group health coverage is to obtain the specific form required by your insurance provider. This form is often available on the insurance company's website, or you can request a copy from their customer service department.
2. Provide personal information: Begin filling out the form by providing your personal information, including your full name, address, phone number, and email address. This information is crucial for the insurance provider to identify your policy and ensure accurate continuation of coverage.
3. Specify the group health plan: Indicate the group health plan that you are seeking continuation coverage for. This can typically be found in your original insurance policy or by contacting your previous employer's human resources department. Include any relevant identification numbers or policy details that are requested on the form.
4. State the reason for continuation: Explain the reason for your need to continue the group health coverage. This could be due to job loss, retirement, divorce, or other qualifying events. Be sure to provide any necessary supporting documentation, such as termination letters, divorce decrees, or proof of retirement, as required by your insurance provider.
5. Select the desired continuation period: Choose the length of time you wish to continue the group health coverage. Typically, you have the option to extend coverage for a certain number of months or until you obtain new insurance. Be mindful of any deadlines or time limitations imposed by your insurance provider or the relevant laws in your jurisdiction.
6. Pay the premium: Determine the premium amount required for the continuation of group health coverage and submit payment according to the instructions provided by your insurance provider. This may involve sending a check, setting up automatic payments, or making an online payment through their designated portal. Failure to pay the premium promptly could result in a loss of coverage.

Who needs continuation of group health?

1. Individuals who have lost their job: If you were previously covered under a group health plan provided by your employer but have now lost your job, you may be eligible for continuation of coverage. This allows you to maintain the same level of health insurance until you secure alternative employment or another insurance option.
2. Retirees: Retirees who were previously covered under their employer's group health plan may also need continuation coverage. This ensures that they have medical insurance during their retirement years and can continue to receive the necessary healthcare services.
3. Divorced or separated individuals: In cases of divorce or legal separation, one spouse may need to continue their coverage under the other spouse's group health plan. This allows them to maintain insurance until they can secure coverage independently.

Remember, the specific eligibility criteria and procedures for continuation of group health coverage may vary depending on your insurance provider and the laws in your jurisdiction. It is important to carefully review the instructions provided by your insurance company and seek clarification if needed.

For pdfFiller’s FAQs

What is continuation of group health?

Continuation of group health refers to the extension of health benefits to certain individuals after they would otherwise lose their benefits. Typically, this applies to employees who are no longer eligible for the group health plan due to a qualifying event.

Who is required to file continuation of group health?

Employers are typically required to offer continuation of group health coverage to eligible employees and their dependents after a qualifying event occurs.

How to fill out continuation of group health?

To fill out continuation of group health, employers must provide the necessary forms to eligible individuals and ensure that the required information is accurately reported, including details about the qualifying event and the coverage being extended.

What is the purpose of continuation of group health?

The purpose of continuation of group health is to provide individuals with the opportunity to maintain their health coverage after experiencing a qualifying event, such as a job loss or reduction in hours.

What information must be reported on continuation of group health?

Information that must be reported on continuation of group health includes details about the qualifying event, the coverage being extended, the individuals eligible for continuation coverage, and the procedures for electing and maintaining coverage.

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