Tennessee Introductory COBRA Letter

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State:
Multi-State
Control #:
US-507EM
Format:
Word
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This Employment & Human Resources form covers the needs of employers of all sizes.

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FAQ

The initial notice, also referred to as the general notice, communicates general COBRA rights and obligations to each covered employee (and his or her spouse) who becomes covered under the group health plan.

Draft a letter stating facts why the COBRA benefits must be reinstated. The letter must provide your full legal name, address, Social Security number and COBRA policy number. The letter should be in proper business format and is best if free from all spelling and grammatical errors.

In addition, employers can provide COBRA notices electronically (via email, text message, or through a website) during the Outbreak Period, if they reasonably believe that plan participants and beneficiaries have access to these electronic mediums.

The initial notice, also referred to as the general notice, communicates general COBRA rights and obligations to each covered employee (and his or her spouse) who becomes covered under the group health plan.

Once COBRA coverage is canceled, there is no option for reinstatement. Note that waiting until the end of the grace period to make payment may not allow enough time within the grace period to reconcile payment if your check is lost in the mail or is rejected by your bank.

If you feel the non-commencement or termination of your benefits under the Federal COBRA regulations was in error, you have the right to file an appeal by writing a letter which explains why you believe the coverage should be reinstated.

A COBRA letter is drafted by the plan administrator with a copy mailed to each qualified beneficiary before the coverage is terminated. The COBRA termination letter format must include the reason why the coverageis being terminated, the rights of the beneficiaries, and the specific date the coverage will end.

Employers should send notices by first-class mail, obtain a certificate of mailing from the post office, and keep a log of letters sent. Certified mailing should be avoided, as a returned receipt with no delivery acceptance signature proves the participant did not receive the required notice.

Employers who fail to comply with the COBRA requirements can be required to pay a steep price. Failure to provide the COBRA election notice within this time period can subject employers to a penalty of up to $110 per day, as well as the cost of medical expenses incurred by the qualified beneficiary.

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Tennessee Introductory COBRA Letter