Ohio COBRA Continuation Coverage Election Form

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

Continuation of insurance coverage with the federal COBRA act requires businesses with 20 or more employees to offer a continuation of group health benefits after job separation. You are entitled to this benefit if you quit your job, were fired, laid off or had your insurance stop due to work hours being reduced.

Ohio's continuation coverage applies to employer sickness and accident coverage and the employer's eligible employees generally, and to an employer not provided for under federal law, such as church plans or governmental plans.

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.

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.

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.

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.

COBRA continuation coverage lets you stay on your employer's group health insurance plan after leaving your job. COBRA stands for the Consolidated Omnibus Budget Reconciliation Act. It's shorthand for the law change that required employers to extend temporary group health insurance to departing employees.

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.

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Ohio COBRA Continuation Coverage Election Form