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EquityLeague COBRA Continuation Coverage Election Form IMPORTANT INSTRUCTIONS: To elect COBRA continuation coverage, complete this Election Form and return it to us. Under federal law, you have 60

How to fill out cobra continuation coverage election

How to fill out cobra continuation coverage election

1. Review the cobra continuation coverage election form provided by your employer or benefits administrator.
2. Fill out the form completely with accurate information including your personal details, date of termination, and reason for termination.
3. Indicate whether you wish to elect or waive cobra continuation coverage.
4. Sign and date the form before submitting it to the designated party within the required timeframe.

Who needs cobra continuation coverage election?

1. Individuals who have recently lost or will lose their group health insurance coverage due to a qualifying event such as termination of employment, reduction of work hours, divorce, or death of the covered employee.

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What is cobra continuation coverage election?

COBRA continuation coverage election allows individuals who experience a qualifying event, such as job loss or reduced work hours, to continue their group health insurance coverage for a limited period.

Who is required to file cobra continuation coverage election?

Eligible individuals who have lost their health coverage due to a qualifying event, their dependents, and the plan administrators are required to file a COBRA continuation coverage election.

How to fill out cobra continuation coverage election?

To fill out a COBRA continuation coverage election, individuals must complete the election notice received from their employer or plan administrator, providing information on the qualifying event and selecting the coverage options desired.

What is the purpose of cobra continuation coverage election?

The purpose of COBRA continuation coverage election is to provide individuals and their families the opportunity to maintain health insurance coverage after losing their group health benefits.

What information must be reported on cobra continuation coverage election?

The COBRA continuation coverage election must report the individual's name, the qualifying event, the date of the event, and the coverage options being elected.