Utah 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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FAQ

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.

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.

Although the earlier rules only covered summary plan descriptions (SPDs) and summary annual reports, the final rules provide that all ERISA-required disclosure documents can be sent electronically -- this includes COBRA notices as well as certificates of creditable coverage under the Health Insurance Portability and

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.

You can reach Covered California at (800) 300-1506 or online at . You can apply for individual coverage directly through some health plans off the exchange.

Will I be able to make changes to my plan elections in the future. Yes. Once COBRA continuation coverage is elected and the 60 day election period has passed, you can drop a plan at any time. But, to change between plans or add new plans, you may need to wait until open enrollment.

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.

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.

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Utah COBRA Continuation Coverage Election Form