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2023 Annual Benefits Enrollment 1CO B R A PAR TI CI PAN T S2023Annual Benefits
Enrollment Guide
Annual benefits enrollment begins Oct. 21
and ends at 8 p.m. Central time Nov. 11, 2022.hr.conocophillips.common
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How to fill out co b r a
How to fill out co b r a
01
Obtain the COBRA election form from your employer or benefits administrator.
02
Fill out your personal information, including name, address, and contact information.
03
Indicate the reason for your COBRA election, such as termination of employment or reduction in work hours.
04
Choose the coverage options that you wish to continue under COBRA.
05
Sign and date the form, and return it to the appropriate party within the specified timeframe.
Who needs co b r a?
01
Individuals who have lost their job and want to continue their employer-sponsored health insurance.
02
Employees who have experienced a reduction in work hours that makes them ineligible for full-time benefits.
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What is co b r a?
Co b r a stands for Consolidated Omnibus Budget Reconciliation Act. It is a federal law that gives employees and their families who lose their health benefits the right to choose to continue group health benefits provided by their group health plan for limited periods of time under certain circumstances.
Who is required to file co b r a?
Employers who offer group health plans and have 20 or more employees are required to file co b r a.
How to fill out co b r a?
To fill out co b r a, employers must provide qualified beneficiaries with a notice of their rights under co b r a, allow them to elect to continue coverage, and administer the continuation of coverage.
What is the purpose of co b r a?
The purpose of co b r a is to ensure that employees and their families continue to have access to health insurance coverage after certain qualifying events trigger a loss of coverage.
What information must be reported on co b r a?
Co b r a must include information about the qualifying event, the individual electing coverage, the coverage options available, and the cost of continuation coverage.
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