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Cobra Basketball Team Rosters
As of .... 12/26/2020
Player First Name
Player Last NameGendergradedobschoolDivisionTeam NameCoachParent/GaurdianAddressCityStateZipPhone 1Phone 2email3rd and 4th Grade
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How to fill out cobra rosters
How to fill out cobra rosters
01
Obtain the Cobra roster form from your employer or benefits administrator.
02
Fill out the form with the necessary information for each employee and dependent who will be covered under COBRA.
03
Ensure all information is accurate and up to date, including names, addresses, and coverage start dates.
04
Submit the completed form to the appropriate party within the designated timeframe.
Who needs cobra rosters?
01
Employers who offer group health insurance benefits to their employees.
02
Employees who are eligible for COBRA continuation coverage due to qualifying events such as job loss or reduction in work hours.
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What is cobra rosters?
Cobra rosters are lists of employees and their dependents who are eligible for continued healthcare coverage under the Consolidated Omnibus Budget Reconciliation Act (COBRA).
Who is required to file cobra rosters?
Employers who offer group health plans and have 20 or more employees are required to file cobra rosters.
How to fill out cobra rosters?
Employers can fill out cobra rosters by listing the names of eligible employees and dependents, along with their coverage details.
What is the purpose of cobra rosters?
The purpose of cobra rosters is to ensure that eligible employees and dependents are informed about their right to continue healthcare coverage after certain events like job loss or reduction in work hours.
What information must be reported on cobra rosters?
Cobra rosters must include the names of eligible employees and dependents, coverage start and end dates, and details of the group health plan.
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