Get the free Continuation of coverage (COBRA) for in-service members

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COBRA/State ContinuationEnrollment/Change Form Fixed Funding Solutions January 2020 March 2021 Employer Name:___ Case/Cert Number:___ Contact your benefits administrator for eligibility and available

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How to fill out continuation of coverage cobra

01

Contact your employer's HR department to determine if you are eligible for continuation of coverage under COBRA.

02

Complete the necessary paperwork provided by your employer within the designated time frame.

03

Make sure to include all required information and documentation with your paperwork.

04

Submit the completed paperwork and payment for premiums to the designated party, such as the employer or the COBRA administrator.

05

Keep track of deadlines and make timely payments to avoid any gaps in coverage.

Who needs continuation of coverage cobra?

01

Individuals who were covered by their employer's group health plan and are no longer eligible due to reasons such as termination of employment, reduction in hours, or certain life events.

02

Spouses, domestic partners, and dependent children of individuals who were covered by the employer's group health plan and are experiencing a loss of coverage.

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What is continuation of coverage cobra?

COBRA (Consolidated Omnibus Budget Reconciliation Act) continuation coverage is a program that allows employees and their dependents to continue receiving group health benefits after experiencing a qualifying event that would result in loss of coverage.

Who is required to file continuation of coverage cobra?

Employers with 20 or more employees who offer group health insurance coverage are required to offer COBRA continuation coverage.

How to fill out continuation of coverage cobra?

Employees can typically fill out COBRA continuation coverage forms provided by their employer or benefits administrator upon experiencing a qualifying event.

What is the purpose of continuation of coverage cobra?

The purpose of COBRA continuation coverage is to provide individuals and their dependents with the option to continue health insurance coverage for a temporary period after experiencing a qualifying event that would result in loss of coverage.

What information must be reported on continuation of coverage cobra?

Information such as the employee's and dependents' names, qualifying event details, coverage start and end dates, and premium payment instructions must be reported on COBRA continuation coverage forms.

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