Get the free Continuation of Benefits Enrollment Form

This form allows students to enroll in a continuation of health insurance coverage after leaving the University of Vermont due to graduation or other reasons.

How to fill out continuation of benefits enrollment

How to fill out Continuation of Benefits Enrollment Form

1. Obtain a copy of the Continuation of Benefits Enrollment Form from your employer or benefits provider.
2. Read the instructions carefully to understand the requirements and process.
3. Fill out your personal information, including your name, address, phone number, and email.
4. Provide details about your employment, such as your employee ID, department, and position.
5. Indicate the type of benefits you are enrolling for, such as health insurance, dental, or vision.
6. Include any dependent information if applicable, such as their names and relationship to you.
7. Review the form for completeness and accuracy before submitting it.
8. Sign and date the form as required.
9. Submit the form to the specified address or email provided in the instructions.

Who needs Continuation of Benefits Enrollment Form?

1. Employees who have had a qualifying event that allows them to continue their benefits coverage after employment ends.
2. Individuals who wish to maintain their health, dental, or vision insurance after a job loss or other certain circumstances.

People Also Ask about

What is benefit of continuation?

Benefit Continuation means the continued participation for Executive and her eligible dependents in the Company Group's medical and dental benefit plans, via an effective election by Executive under COBRA.

What is benefit continuation?

In general, COBRA is expensive because you pay both your employee side of premiums AND the employer side of premiums. For example, this could be a total of like $600 for a single person that's young.

What is the coverage continuation benefit?

Continuation coverage allows someone who recently lost their employer-based health coverage to continue their current insurance policy as long as they pay the full monthly premiums. Continuation coverage falls into four categories: COBRA, Cal-COBRA, Conversion, and HIPAA.

What is the 60 day loophole for cobras?

Benefit Continuation means the continued participation for Executive and her eligible dependents in the Company Group's medical and dental benefit plans, via an effective election by Executive under COBRA.

What is a benefits enrollment form?

Benefits enrollment, also known as open enrollment or benefits election, refers to the process through which employees choose and sign up for the employee benefits offered by their employer. These benefits often include health insurance, dental insurance, vision insurance, life insurance, retirement plans, and similar.

What is the meaning of continuation of benefits?

Continuation of Benefits means the continuation of all benefits (to the extent permissible under the terms and conditions of each applicable employee benefit program and applicable law) in which you participate as of the date of the Qualifying Event for the term of the Severance Period, provided that you continue to

What is continued benefits?

If you are not on automatic payment, you will receive a Claim for Continued Disability Benefits (DE 2500A) every two weeks to certify that your disability continues. Your benefits will stop if you do not complete and return the DE 2500A.

For pdfFiller’s FAQs

What is Continuation of Benefits Enrollment Form?

The Continuation of Benefits Enrollment Form is a document that allows eligible individuals to continue their benefits coverage after a qualifying event, such as job loss or change in employment status.

Who is required to file Continuation of Benefits Enrollment Form?

Individuals who have experienced a qualifying event that affects their benefits coverage, such as termination of employment or reduction in hours, are required to file the Continuation of Benefits Enrollment Form.

How to fill out Continuation of Benefits Enrollment Form?

To fill out the Continuation of Benefits Enrollment Form, individuals should provide personal information, details regarding the qualifying event, and any applicable coverage selections, ensuring all required sections are completed accurately.

What is the purpose of Continuation of Benefits Enrollment Form?

The purpose of the Continuation of Benefits Enrollment Form is to facilitate the continuation of health insurance and other benefits for individuals following certain life events that would typically result in a loss of coverage.

What information must be reported on Continuation of Benefits Enrollment Form?

The information required on the Continuation of Benefits Enrollment Form typically includes the individual's personal details, qualifying event information, desired coverage options, and any dependents that will also be enrolling.