Massachusetts COBRA Continuation Coverage Election Form

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

This form allows an individual to elect COBRA continuation coverage.
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FAQ

Cal-COBRA is a California Law that lets you keep your group health plan when your job ends or your hours are cut. It may also be available to people who have exhausted their Federal COBRA.

There are several other scenarios that may explain why you received a COBRA continuation notice even if you've been in your current position for a long time: You may be enrolled in a new plan annually and, therefore, receive a notice each year. Your employer may have just begun offering a health insurance plan.

Massachusetts Has Mini-COBRA COBRA applies to self-funded and group plans offered by employers with 20 or more employees. Mini-COBRA does not apply to self-funded plans.

COBRA the Consolidated Omnibus Budget Reconciliation Act -- requires group health plans to offer continuation coverage to covered employees, former employees, spouses, former spouses, and dependent children when group health coverage would otherwise be lost due to certain events.

The Consolidated Omnibus Budget Reconciliation Act (COBRA) gives workers and their families who lose their health benefits the right to choose to continue group health benefits provided by their group health plan for limited periods of time under certain circumstances such as voluntary or involuntary job loss,

The general notice describes general COBRA rights and employee obligations. This notice must be provided to each covered employee and each covered spouse of an employee who becomes covered under the plan. The notice must be provided within the first 90 days of coverage under the group health 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.

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.

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Massachusetts COBRA Continuation Coverage Election Form