Cobra Election Form Online

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State:
Multi-State
Control #:
US-322EM
Format:
Word; 
Rich Text
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Description

The COBRA Continuation Coverage Election Form is a crucial document for individuals wishing to continue their health coverage after employment ends. This online form allows users to elect COBRA coverage under the specified plan, ensuring they have the necessary healthcare benefits during transitional periods. Users must complete the form and submit it within 60 days of receiving the notice to retain their rights. Key features of the form include sections to provide personal information, coverage options, and a signature line for validation. Clear instructions assist users in filling out the form correctly and emphasize the importance of timely submission to avoid losing coverage rights. This form is particularly useful for attorneys, partners, owners, associates, paralegals, and legal assistants, as it helps ensure compliance with federal regulations and protects clients' health insurance options. Additionally, it offers a straightforward process for electing coverage, enhancing accessibility for users with varying levels of legal expertise. By understanding this form, legal professionals can better assist clients in navigating health insurance choices following job loss.
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  • 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

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.

Qualified beneficiaries must be given an election period of at least 60 days during which each qualified beneficiary may choose whether to elect COBRA coverage. This period is measured from the later of the date of the qualifying event or the date the COBRA election notice is provided.

To be eligible for COBRA, your group policy must be in force with 20 or more employees covered on more than 50 percent of its typical business days in the previous calendar year.

Canceling COBRA coverage Enter a support request in the online message center. Send a letter to WageWorks requesting termination of your COBRA coverage (note that certain cancellation requests are subject to the employer's applicable group health plan provisions).

There are state and federal COBRA continuation coverage laws in place in Massachusetts that give employees and their families who would lose their group health plan because of a serious life event the right to continue their health benefits, usually at their own expense, for a limited period of time.

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Cobra Election Form Online