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721 South Parker, Suite 200, Orange, CA 92868 Phone: (866) 4129279 www.choicebuilder.comCOBRA Dependent Qualifying/Triggering Event Notification **THIS IS NOT AN APPLICATION FOR COBRA COVERAGE**Complete

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How to fill out continuation coverage - california

01

Step 1: Contact your employer's benefits administrator to request the necessary paperwork for continuation coverage.

02

Step 2: Complete the election form and return it to the benefits administrator within the specified time frame.

03

Step 3: Make the required premium payments to maintain coverage.

04

Step 4: Review the terms and conditions of the continuation coverage to understand your rights and responsibilities.

05

Step 5: Notify the benefits administrator of any changes in your status that may affect your eligibility for continuation coverage.

Who needs continuation coverage - california?

01

Individuals who have lost their job and thus their employer-provided health insurance

02

Dependents of covered employees who lose coverage due to a qualifying event such as divorce or death of the employee

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What is continuation coverage - california?

Continuation coverage in California refers to the right of employees and their dependents to continue health insurance coverage after a qualifying event that would normally result in loss of coverage.

Who is required to file continuation coverage - california?

Employers in California with 20 or more employees are required to offer continuation coverage to eligible employees and their dependents.

How to fill out continuation coverage - california?

To fill out continuation coverage in California, employers must provide the necessary forms to eligible employees and ensure that the required information is accurately reported.

What is the purpose of continuation coverage - california?

The purpose of continuation coverage in California is to allow employees and their dependents to maintain health insurance coverage when they would otherwise lose it due to qualifying events.

What information must be reported on continuation coverage - california?

Information such as the effective date of coverage, the length of coverage, and the premiums to be paid must be reported on continuation coverage forms in California.

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