Washington COBRA Continuation Coverage Election Form

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

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.

Key Takeaways. COBRA provides a good option for keeping your employer-sponsored health plan for a while after you leave your job. Although, the cost can be high. Make an informed choice by looking at all your options during the 60-day enrollment period, and don't focus on the premium alone.

How Long Does COBRA Last After You Quit? You may remain on your former employer's COBRA insurance plan for up to 18 months. Depending on your circumstances you or your qualified dependents may be eligible for up to 36 months of continuing coverage.

Eligibility. You're eligible to continue your health coverage for up to 18 months if either of these occur: Your employment ends (unless it's due to gross misconduct)

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.

Eligibility. You're eligible to continue your health coverage for up to 18 months if either of these occur: Your employment ends (unless it's due to gross misconduct)

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.

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.

Q11: How long does COBRA coverage last? COBRA requires that continuation coverage extend from the date of the qualifying event for a limited period of 18 or 36 months.

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Washington COBRA Continuation Coverage Election Form