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  • Connecticut Continuation Coverage Election Notice Fillable Form

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COBRA CONTINUATION COVERAGE ELECTION NOTICE (DATE) Dear: (NAME(S)): This notice contains important information about your right to continue your health care coverage under Insurance Company name.

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The 60-day clock starts ticking on either the day of the qualifying event (e.g., the termination or resignation date) or the date that notice of eligibility is given by the COBRA administrator to the worker, whichever is later.

Yes, leaving your job and losing eligibility for job-based health coverage will trigger a special enrollment opportunity that lasts for 60 days.

On Average, The Monthly COBRA Insurance Premium Cost Is $400 – 700/month Per Individual. If you do not have pre-existing health conditions, you may visit the health enrollment center to find temporary health insurance plans that offer significant savings of up to 70% off an employer's COBRA coverage.

In Connecticut, two types of COBRA insurance are offered: federal COBRA continuation coverage and state continuation coverage. Federal COBRA covers employees who have lost their jobs, while state continuation coverage covers employees who are leaving a company with fewer than 20 employees.

COBRA coverage lets you pay to stay on your job-based health insurance for a limited time after your job ends (usually 18 months). You usually pay the full premium yourself, plus a small administrative fee. Contact your employer to learn about your COBRA options.

COBRA continuation coverage generally lasts 18 months, or 36 months for dependents in certain circumstances.

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© Copyright 1997-2025
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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