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.
Yes, with COBRA, you'll enjoy the same benefits as before. It's like taking the whole package with you, just in case life throws you a curveball.
If you miss the deadline, it’s like letting the train leave the station without you. Unfortunately, you won’t be able to get COBRA coverage at that point, so keep an eye on the clock!
Yes! You can cover your family members like a cozy blanket. Just make sure they were covered under the plan when you were employed.
You’ll need to fill out the election form and send it back by the due date. It's like securing your ticket to ride—make sure you don’t miss the bus!
Typically, you can maintain COBRA coverage for up to 18 months, but sometimes it can stretch to 36 months depending on your situation. Think of it as a temporary lifebuoy.
If you were part of a group health plan and lost your job or had your hours cut, you may qualify. It’s meant for folks who need a little extra time to find their footing.
COBRA Continuation Coverage is a way to keep your health insurance after leaving a job. It’s like holding on to a safety net when you jump into the unknown.
Trusted and secure by over 3 million people of the world’s leading companies
Pittsburgh Pennsylvania Formulario de elección de continuación de cobertura COBRA