COBRA election form

njjel · April 2005

I checked on the DOL site but didn't find what I was looking for which is a sample for to use for COBRA election. Does anyone know where I can find it?

pork1 · April 2005

NJJEL: Our COBRA notice program is developed by our 3rd Party administrator in their letter head. We provide them with the termination notice and they go into action to get the notice sent and enrollment accomplished, accordingly. Our main worry is to get the termination information transmitted in a timely manner and then file it away.

I recommend you contact your medical plan or your 3rd party administrator, they will have all of the required regulatory information for your medical plan.

PORK

PORK

njjel · April 2005

Been there and done that Pork. Actually, I seeking the form that will comply with the new regs from last year that are effective (for us at least) 1/1/05.

irenesmsaclaims · April 2005

The final COBRA rules from 2004 did not require a new election form. They clarified and specified notification provisions for qualifying events, added early termination of COBRA and the disqualification of COBRA initially, effective the first day of the plan year after November 26, 2004. As Pork said, your third party COBRA administrator or the insurance company should be on top of this.

It's not a form; it is a body of rules governing COBRA administration, which should be embodied in your COBRA general notice, which can be a part of your plan document or SPD.

Sunny · April 2005

I found slight changes in the notice - the new language was provided to me by my carrier but I would be glad to send you what I have.

njjel · April 2005

Sunny - That would be much appreciated. fax is 856 964 0228. THANKS!

COBRA election form

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