Get Cobra Letter Form

The COBRA termination letter format must include the reason why the coverageis being terminated, the rights of the beneficiaries, and the specific date the coverage will end. The letter is customized to fit theD particular plan offered by the company as well as particulars related to the employee.

COBRA Qualifying Event Notice The employer must notify the plan if the qualifying event is: Termination or reduction in hours of employment of the covered employee, • Death of the covered employee, • Covered employee becoming entitled to Medicare, or • Employer bankruptcy.

Voluntary or involuntary termination of the covered employee's employment for any reason other than gross misconduct. Reduction in the hours worked by the covered employee. Covered employee becoming entitled to Medicare. Divorce or legal separation from the covered employee.

Qualifying Event: At the end of your employment or because of reduction of hours (not maintain full-time status) you will receive this letter. It is VERY important that you review this letter and make your decision if you will need to continue your coverage through COBRA.

COBRA continuation coverage lets people who qualify keep their health insurance after their job ends, so it's not surprising that people who receive a COBRA notice might think they're job will soon be terminated. Getting a COBRA notice doesn't necessarily mean you'll be fired or laid off soon, though.

Employers should send notices by first-class mail, obtain a certificate of mailing from the post office, and keep a log of letters sent. Certified mailing should be avoided, as a returned receipt with no delivery acceptance signature proves the participant did not receive the required notice.

Initial COBRA Notice. Date of Notice: Notice of Rights Under COBRA. The COBRA statute requires that continuation coverage be offered to covered employees and their covered dependents in order to continue their State-sponsored health/dental/vision benefit(s) in the event coverage is lost due to certain qualifying events ...