Can I cancel my COBRA coverage at any time?

COBRA is generally month-to-month coverage and can be terminated at any time subject to applicable plan provisions. You can send a letter to WageWorks requesting termination of your COBRA coverage or you can simply stop paying premiums and your COBRA coverage will be terminated for non-payment.

How do I write a COBRA termination letter?

The notice must explain the reason coverage has terminated, provide the date of termination and describe any rights the qualified beneficiary may have to elect alternative group or individual coverage, such as a conversion right (29 C.F.R. 2590.606-4(d)).

How do I cancel my COBRA Discovery benefits?

To cancel your COBRA plan you will need to notify your previous employer or the plan administrator in writing, requesting to terminate the insurance. After you stop your COBRA insurance, your former employer should send you a letter affirming termination of that health insurance.

How do you call Cobra?

Administration electronically or call toll free 1-866-444-3272.

How do I contact Cobra Insurance California?

You can reach Covered California at (800) 300-1506 or online at .coveredca.com. You can apply for individual coverage directly through some health plans off the exchange.

How does COBRA work after being terminated?

You may be able to keep your job-based health plan through COBRA continuation coverage. 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.

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Discovery Benefits COBRA Benefits Termination Form

Get Discovery Benefits COBRA Benefits Termination Form

COBRA Benefits Termination Form This form is to terminate one or more benefits continued through COBRA. If participating in ACH please note Discovery Benefits needs to receive notification at least 15 days prior to the 1st of the month of your requested termination. If this form is received after that timeframe Discovery Benefits cannot guarantee that the ACH payment for that month will be cancelled. However if a payment is withdrawn you will be refunded via check. Benefits Effective Dates of Termination mm/dd/yyyy Person s Affected PQB and/or Dependents Medical Dental Vision Other If the reason for requesting termination is due to death of the former employee divorce or legal separation from the former employee or a dependent child s ceasing to be a dependent please use the COBRA Second Qualifying Event Form. I understand my submission of this form is a request to terminate the specified benefit s indicated above. When terminating all benefits with an overpayment balance remaining you will only receive a refund check if the amount is greater than 25. 00. Lesser amounts are used by the employer who sponsors the group health plan to pay for plan administration expenses. Standard processing time for refunds is 15 business days from the date this completed form is received. Step 1 Primary Qualified Beneficiary Information Required Fields - Primary Qualified Beneficiary Name First MI Last Social Security Number Previous Employer Do not abbreviate Day Telephone Email Address Step 2 Benefit Termination Information Please specify the benefit s you are requesting to discontinue through COBRA. When terminating all benefits with an overpayment balance remaining you will only receive a refund check if the amount is greater than 25. 00. Lesser amounts are used by the employer who sponsors the group health plan to pay for plan administration expenses. Standard processing time for refunds is 15 business days from the date this completed form is received* Step 1 Primary Qualified Beneficiary Information Required Fields - Primary Qualified Beneficiary Name First MI Last Social Security Number Previous Employer Do not abbreviate Day Telephone Email Address Step 2 Benefit Termination Information Please specify the benefit s you are requesting to discontinue through COBRA. Please also indicate the effective date you are requesting coverage to terminate as well as the person s affected by the change. Further I understand Discovery Benefits will contact me if my request to terminate coverage is denied for any reason* Date Spouse Signature Only required if coverage is being terminated for the spouse but not the PQB Date C002. When terminating all benefits with an overpayment balance remaining you will only receive a refund check if the amount is greater than 25. 00. Lesser amounts are used by the employer who sponsors the group health plan to pay for plan administration expenses. 00. Lesser amounts are used by the employer who sponsors the group health plan to pay for plan administration expenses. Standard processing time for refunds is 15 business days from the date this completed form is received* Step 1 Primary Qualified Beneficiary Information Required Fields - Primary Qualified Beneficiary Name First MI Last Social Security Number Previous Employer Do not abbreviate Day Telephone Email Address Step 2 Benefit Termination Information Please specify the benefit s you are requesting to discontinue through COBRA. .

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