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Download a copy, print it, send it by email, or mail it via USPS—whatever works best for your next step.

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We protect your documents and personal data by following strict security and privacy standards.
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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.
COBRA Election Notice The election notice describes their rights to continuation coverage and how to make an election. The election notice should include: 2022 The name of the plan and the name, address, and telephone number of the plan's COBRA.
The COBRA election notice should describe all of the necessary information about COBRA premiums, when they are due, and the consequences of payment and nonpayment. Plans cannot require qualified beneficiaries to pay a premium when they make the COBRA election.
The purpose of this letter is to inform you of your rights and responsibilities as a plan participant. Qualifying Event: At the end of your employment or because of reduction of hours (not maintain full-time status) you will receive this letter.
The Department of Labor has developed a model Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) continuation coverage extended election notice that the Plan may use to provide the election notice to qualified beneficiaries currently enrolled in COBRA continuation coverage due to reduction in hours or
COBRA generally requires that group health plans sponsored by employers with 20 or more employees in the prior year offer employees and their families the opportunity for a temporary extension of health coverage (called continuation coverage) in certain instances where coverage under the plan would otherwise end.
Adam's initial 60-day COBRA election deadline would generally be January 30, 2021 (i.e., 60 days from December 1, 2020). On December 31, 2020, Adam elects COBRA coverage retroactive to December 1, 2020.