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.
Don’t hesitate to reach out to your former employer’s HR department or the plan administrator. They’re your go-to people for guidance—think of them as your friendly navigators in this health coverage journey.
Generally, you can’t change your plan while on COBRA. You're sticking with what you had. It's like driving the same car until you hit the end of the road.
If you miss out, you might miss your chance to get back on the coverage train until the next opportunity comes along. It’s crucial to stay on top of the dates.
Your employer will send you a notice. Just make sure to fill out the forms and send them back on time. It’s like a quick game of catch—don’t let the ball drop!
Typically, you can keep it for up to 18 months, but sometimes longer if you're facing special circumstances. Think of it like a temporary umbrella for unexpected rain.
If you worked for a company with 20 or more employees and your job ends, or your hours get cut, you might be eligible. It's like having a safety net while you figure out your next step.
COBRA continuation coverage is a way to keep your health insurance after leaving a job. It's like holding onto a lifeline when you're jumping into a new adventure.
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Mesa Arizona Formulario de elección de continuación de cobertura COBRA