Arkansas COBRA Continuation Coverage Election Form

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

This form allows an individual to elect COBRA continuation coverage.
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How to fill out COBRA Continuation Coverage Election Form?

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FAQ

When does COBRA continuation coverage startCOBRA is always effective the day after your active coverage ends. For most, active coverage terminates at the end of a month and COBRA is effective on the first day of the next month.

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

COBRA generally requires that group health plans sponsored by employers with 20 or more employees in the prior year offer employees and their families the opportunity for a temporary extension of health coverage (called continuation coverage) in certain instances where coverage under the plan would otherwise end.

COBRA is always retroactive to the day after your previous coverage ends, and you'll need to pay your premiums for that period too. One advantage of enrolling right away is that you can keep seeing doctors and filling prescriptions without a break in coverage. COBRA allows you to keep the exact same benefits as before.

The qualifying event for COBRA purposes is the employee's loss of employment date. However, the election period does not end until 60 days from the sent date of the election form to the employee or until 60 days after the loss of coverage, whichever is later.

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.

COBRA requires that continuation coverage extend from the date of the qualifying event for a limited period of 18 or 36 months. The length of time depends on the type of qualifying event that gave rise to Page 6 6 the COBRA rights.

Federal law requires that most group health plans (including this Plan) give employees and their families the opportunity to continue their health care coverage through COBRA continuation coverage when there's a qualifying event that would result in a loss of coverage under an employer's plan.

State continuation coverage refers to state laws that allow people to extend their employer-sponsored health insurance even if they're not eligible for extension via COBRA. As a federal law, COBRA applies nationwide, but only to employers with 20 or more employees.

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Arkansas COBRA Continuation Coverage Election Form