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, you can drop COBRA coverage at any time, but it’s wise to make sure you have alternative health insurance lined up first.
If you missed the deadline, don't panic! Contact your former employer or the plan administrator right away; there might be options available for you.
Typically, COBRA coverage can last for up to 18 months, but there are situations where you might qualify for a longer period.
To elect COBRA, you usually need to fill out an election form your employer provides within a certain time frame after your qualifying event.
If you were covered by your employer's health plan and you lose that coverage due to job loss or other qualifying events, you likely can elect COBRA coverage.
COBRA continuation coverage is a federal law that lets you keep your health insurance for a while after you leave your job or experience another qualifying event.
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Wichita Kansas Formulario de elección de continuación de cobertura COBRA