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  • Application For Continuation Of Group Health Coverage (cobra)

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In Topeka (785) 291-7000 In Kansas (800) 432-0216 1133 SW Topeka Boulevard Topeka, Kansas 66629-0001 Web site: www.bcbsks.com Clear Data APPLICATION FOR CONTINUATION OF GROUP HEALTH COVERAGE (COBRA).

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Massachusets Mini-COBRA Law The 1996 Massachusetts Mini-COBRA Law allows all employees to continue their group health insurance coverage for a limited time if they lose it due to a reduction in hours or termination of employment.

If your group coverage ends due to employment termination or reduction in employment hours, COBRA continuation coverage may last for up to 18 months. If it ends due to any other qualifying events listed above, you may maintain COBRA continuation coverage for up to 36 months.

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.

Enroll in COBRA If your employer helped cover your health insurance while you were employed, it's now up to you to fund the entire tab. Also, COBRA typically expires after 18 months from the date you quit.

New York State law requires small employers (less than 20 employees) to provide the equivalent of COBRA benefits. You are entitled to 36 months of continued health coverage at a monthly cost to you of 102% of the actual cost to the employer which may be different from the amount deducted from your paychecks.

How long does COBRA coverage last? COBRA requires that continuation coverage extend from the date of the qualifying event for a limited period of 18 or 36 months.

If you are an employee of the Commonwealth of Massachusetts, you have the right to choose COBRA coverage if you lose your group health coverage because your hours of employment are reduced or your employment ends for reasons other than gross misconduct.

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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