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Get COBRA Appeal Form - Pbs.us.com

You have the right to file an appeal by writing a letter which explains why you believe the coverage should be reinstated. Steps to Appeal 1. Your appeal must be submitted in writing and mailed or faxed to: WageWorks, Inc. Attn: COBRA Appeals PO Box 4594 Greenwood Village, CO 80155-4594 Fax: (303) 221-2785 2. Your appeal must be received within 180 days of the date you receive notice that your COBRA coverage has been terminated or has not commenced. 3. You are welcome to submit additional info.

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