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  • Arkansas State Group Continuation Coverage Election Form

Get Arkansas State Group Continuation Coverage Election Form

SUBMIT THIS FORM TO: QualChoice PO Box 25610 Little Rock, AR 72221-5610 Arkansas State Group Continuation Coverage Election Form Employee's Name: ID #: Dependent Name(s): Insurer Former Employer:.

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State continuation coverage refers to state laws that enable employees to extend their employer-sponsored group health insurance even if they are not eligible for an extension through COBRA. While COBRA law applies throughout the U.S., it is only applicable to employers with 20 or more employees.

Under COBRA, participants, covered spouses and dependent children may continue their plan coverage for a limited time when they would otherwise lose coverage due to a particular event, such as divorce (or legal separation).

The Consolidated Omnibus Budget Reconciliation Act (COBRA) gives workers and their families who lose their health benefits the right to choose to continue group health benefits provided by their group health plan for limited periods of time under certain circumstances such as voluntary or involuntary job loss, ...

COBRA coverage follows a "qualifying event". An example of a qualifying event would be if your hours were reduced or you lost your job (as long as there was no gross misconduct). Your employer must mail you the COBRA information and forms within 14 days after receiving notification of the qualifying event.

Generally, your coverage under COBRA will be the same coverage you had while you were an employee. This is helpful if you would like to continue to see your same doctors and receive the same health plan benefits.

Under COBRA, a retired employee can receive the same health insurance coverage for up to 18 months. But you must pay the entire premium - part of which your employer probably previously covered. In some cases, people who opt to use COBRA also have to pay an extra 2% to cover administrative fees associated with it.

Consumers may also extend COBRA continuation coverage longer than the initial 18-month period with a second qualifying event —e.g., divorce or death— up to an additional 18 months, for a total of 36 months.

COBRA is expensive, but it could be worth it if you can't find a better alternative. If you have a lot of medical needs and can't be without coverage, COBRA is an easy way to continue with the same network and providers.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232