If you choose to elect COBRA continuation coverage, you should use the election form provided later in this notice. Why am I getting this notice? You're ... |
You have 60 days to enroll in COBRA once your employer-sponsored benefits end. Even if your enrollment is delayed, you will be covered by COBRA starting the day ... |
This form is an election notice for the continuation of COBRA coverage for group health plans. It is given as part of COBRA administration procedures in ... |
Download the US Department of Labor (DOL) COBRA Model Election Notice under the Regulations section of the DOL's COBRA Continuation Coverage. |
If you choose to elect COBRA continuation coverage, you should use the Election Form provided later in this notice. The American Rescue Plan Act of 2021 (ARP) ... |
Your right to elect COBRA continuation coverage is detailed in this notice. An Election Form is enclosed and should be completed, signed and returned to the ... |
To elect COBRA continuation coverage, follow the instructions on the next page to complete the enclosed Election Form and submit it to us. If you do not elect ... |
If you wish to elect coverage through COBRA you must: complete and return this COBRA Notification/Election Form. complete and return insurance applications ... |
COBRA Notice of Continuation ("Notice"). • This Notice should be completed by the Employer and a copy of the Notice be given to the Employee. |
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