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 have questions about COBRA, don't hesitate to reach out to your employer’s HR department or your health plan provider. They’re there to help you navigate the waters!
Absolutely! You can decide not to elect COBRA coverage. Just keep in mind, if you go that route, you’ll need to find another way to cover your health needs.
If you miss the deadline to elect COBRA, you might lose the chance to continue your health coverage. It’s like missing the bus—there won’t be another one for a while.
Yes! You should notify your employer or plan administrator if you want to elect COBRA coverage. They’ll need to set the wheels in motion.
Typically, you can keep it for 18 months after job loss. In some cases, it may extend to 36 months, like when a family member loses coverage.
If you worked for a company with 20 or more employees and lost your job or reduced hours, you're usually eligible. It applies to you and your family members covered under the same plan.
COBRA continuation coverage lets you keep your health insurance after leaving a job. It’s like a safety net, so you don’t fall through the cracks in a tough situation.
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Newark New Jersey Formulario de elección de continuación de cobertura COBRA