Cobra Coverage Application For How Long

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Multi-State
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US-322EM
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Word; 
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Description

The COBRA Continuation Coverage Election Form is a critical document that allows individuals the opportunity to continue their health insurance coverage under federal law. Users must complete and submit this form within 60 days from the date of the notice to elect COBRA continuation coverage. Failure to do so may result in the loss of this right. This form allows users to specify their selected coverage options and requires personal details such as name, date of birth, relationship to employee, and Social Security number. The completion process involves careful filling out of the required fields and sending the form via mail or other specified methods by the due date. It is essential for users who initially reject COBRA coverage to note that they may still elect coverage before the deadline by completing the form. This document is particularly useful for attorneys, partners, owners, associates, paralegals, and legal assistants as it guides them and their clients through the process of securing health insurance under COBRA, emphasizing timelines and submission methods necessary to preserve their rights.
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  • Preview COBRA Continuation Coverage Election Form
  • Preview COBRA Continuation Coverage Election Form
  • Preview COBRA Continuation Coverage Election Form

How to fill out COBRA Continuation Coverage Election Form?

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FAQ

Q8: How long do I have to elect COBRA coverage? If you are entitled to elect COBRA coverage, you must be given an election period of at least 60 days (starting on the later of the date you are furnished the election notice or the date you would lose coverage) to choose whether or not to elect continuation coverage.

California law requires most companies to extend COBRA benefits for a total of 36 months when a person is entitled to fewer than 36 months of federal COBRA coverage. Some companies are exempt from this requirement.

Who Is Entitled to Continuation Coverage? You must meet three basic requirements to be entitled to elect COBRA continuation coverage: Your group health plan must be covered by COBRA; ? A qualifying event must occur; and ? You must be a qualified beneficiary for that event.

If the qualifying event is the death of the covered employee, divorce or legal separation of the covered employee from the covered employee's spouse, or the covered employee becoming entitled to Medicare, COBRA for the spouse or dependent child lasts for 36 months.

While COBRA is temporary, in most circumstances, you can stay on COBRA for 18 to 36 months.

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Cobra Coverage Application For How Long