Este formulario permite que una persona elija la continuación de la cobertura de COBRA.
Para su conveniencia, debajo del texto en español le brindamos la versión completa de este formulario en inglés.
For your convenience, the complete English version of this form is attached below the Spanish version.
If you miss the 60-day deadline, you may lose your right to COBRA coverage. It’s like missing the bus – you’ll have to wait for the next opportunity, which could mean finding another insurance plan.
Once you elect COBRA coverage, you can't change your mind for that period. So, it’s important to consider if it’s the right choice for you and your family before signing on the dotted line.
To elect COBRA coverage, you must fill out the election form provided by your employer within 60 days after your qualifying event. It’s crucial to act quickly to keep your coverage.
Typically, you can stay on COBRA for up to 18 months after your qualifying event. Sometimes, depending on circumstances, that period can be extended to 36 months for certain events.
You're eligible for COBRA coverage in Indianapolis if you were part of a group health plan and had a qualifying event, like job loss or a reduction in hours. Your spouse and dependent children may also be covered.
COBRA stands for the Consolidated Omnibus Budget Reconciliation Act. It allows you to keep your health insurance after leaving your job. In Indianapolis, if you've lost your job or had your hours reduced, you can elect to continue your health coverage for a limited time.
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Indianapolis Indiana Formulario de elección de continuación de cobertura COBRA