Get the free COBRA: Continuation Of Coverage - Dental

Rev. 12/2024 Reset the FormUniversal Enrollment Form Medical/Dental/Vision For Active, Retiree, COBRA, Surviving Spouse Participants FOR OFFICE USE ONLY: Plan Type___ Plan Code___ Coverage Code___

How to fill out cobra continuation of coverage

How to fill out cobra continuation of coverage

1. Identify qualifying events that make you eligible for COBRA continuation of coverage.
2. Receive a COBRA election notice from your employer or plan administrator after the qualifying event.
3. Carefully review the notice for costs, coverage, and deadlines.
4. Complete the COBRA election form included in the notice.
5. Submit the completed election form to your employer or plan administrator within the designated timeframe.
6. Make the initial premium payment to activate coverage, ensuring it's within the allowed time period.
7. Keep a record of your payments and any correspondence related to your COBRA coverage.

Who needs cobra continuation of coverage?

1. Employees who lose their job or experience a reduction in hours.
2. Employees covered under a spouse's plan who get divorced.
3. Dependents of covered employees who lose coverage due to certain events.
4. Retirees and their dependents in the case of employer bankruptcy.

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What is cobra continuation of coverage?

COBRA continuation of coverage is a federal law that allows individuals and their families to continue their group health insurance coverage for a limited period after a qualifying event, such as job loss or reduction in work hours.

Who is required to file cobra continuation of coverage?

Employers with 20 or more employees who offer group health plans are required to provide COBRA continuation coverage to eligible employees and their dependents following a qualifying event.

How to fill out cobra continuation of coverage?

To fill out COBRA continuation coverage, an eligible individual must complete the COBRA election form provided by the employer, indicating their desire to continue coverage, and submit it according to the instructions provided.

What is the purpose of cobra continuation of coverage?

The purpose of COBRA continuation of coverage is to provide individuals and families the option to maintain their health insurance coverage after experiencing a qualifying event, ensuring they do not face a sudden loss of coverage.

What information must be reported on cobra continuation of coverage?

The COBRA continuation coverage report must include information such as the individual’s name, the qualifying event, the type of coverage being continued, the start and end dates of coverage, and any premium costs.