Washington Acknowledgment of Receipt of COBRA Notice

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State:
Multi-State
Control #:
US-502EM
Format:
Word
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Description

This Employment & Human Resources form covers the needs of employers of all sizes.

How to fill out Acknowledgment Of Receipt Of COBRA Notice?

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FAQ

These state laws are the mini-COBRA laws. According to the National Conference of State Legislatures, 40 states and the District of Columbia have some sort of mini-COBRA law. (Alabama, Alaska, Arizona, Delaware, Idaho, Indiana, Michigan, Montana, Pennsylvania and Washington had no such laws as of May 2009.)

As COBRA is the same employer-sponsored you had previously, you would need to contact the COBRA Plan Administrator. If you are unsure you that is, contact the HR Department at the business who provided the group health plan.

You should get a notice in the mail about your COBRA and Cal-COBRA rights. You have 60 days after being notified to sign up. If you are eligible for Federal COBRA and did not get a notice, contact your employer.

Author: Gloria Ju. The federal Consolidated Omnibus Budget Reconciliation Act (COBRA) allows employees and their dependents to continue receiving employer-provided health insurance in the event they lose their job or would otherwise lose health care coverage.

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.

If you need further information about COBRA, ACA, HIPAA, or ERISA, visit the Employee Benefits Security Administration's (EBSA) Website at dol.gov/ebsa/complianceassistance.html. Or you may contact EBSA electronically at askebsa.dol.gov or call toll free 1-866-444-3272.

To access the COBRA portal, click on the Login button in the upper right hand corner of the website, then click "Members" from the dropdown menu. From the Member Login page, click the "COBRA Login" button and you will be directed to the COBRA portal page.

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)

Unlike other states with mini-COBRA programs, Washington has not enacted a state law that provides a similar continuation of healthcare coverage for employees who work for businesses with fewer than 20 employees or who otherwise do not qualify for COBRA continuation coverage under federal law.

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.

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Washington Acknowledgment of Receipt of COBRA Notice