Web Results

www.dol.gov/sites/default/files/ebsa/laws-and-regulations/laws/cobra/model-election-notice.doc

Model COBRA Continuation Coverage Election Notice ... plans (including this Plan) give employees and their families the opportunity to continue ... there's a “ qualifying event” that would result in a loss of coverage under an employer's plan . ... For example, if you move to other coverage you may pay more out of pocket than ...

www.pilot-benefits.com/docs/Cobra-Sample-Letter.pdf

to 36 months in certain events (Death of the employee, Medicare entitlement, Divorce or legal ... Each payment is due to the employer the ______ of the month. ... COBRA. Consolidated Omnibus Budget Reconciliation Act. Sample Letter for ...

www.bizfilings.com/toolkit/tools/tools-forms/cobra-rights-notification-letter-template

The COBRA Rights Notification Letter Template contains a model form of the letter that all employees must receive either from their employer or from the benefit ...

www.auxillium.com/VirtualHR/cobraini.doc

RE: Enclosed COBRA Initial Notification Letter ... Under federal law, <Company name> is required to offer covered employees and covered family members the ...

www.shrm.org/resourcesandtools/tools-and-samples/hr-qa/pages/whatnoticesmustbeprovidedtoqualifiedbeneficiariesundercobra.aspx

Jul 15, 2015 ... Note: Multi-employer plans have special rules for COBRA notice requirements. Failure ... This notice must be provided to each covered employee and each covered spouse of an ... See the DOL's sample COBRA notices here.

www.shrm.org/resourcesandtools/tools-and-samples/hr-forms/pages/cms_009553.aspx

Aug 22, 2014 ... Tools & Samples; Employee Handbooks · Express Requests · How-To ... See NOTE TO EMPLOYER at the end of this notice for additional information.] ... COBRA continuation coverage terminated or will terminate for the ... _____ The employer ceased to provide any group health plan for its employees.

www.grpbenefits.net/New/Forms/cobra_notification.htm

Sample letter to be used for COBRA or State continuance notification. ... As an employee of [Name of Employer] covered by [Group Health Plan Name], you have ...

ccmhg.com/wp-content/uploads/2012/09/Sample_Initial_Notice.pdf

This notice generally explains COBRA continuation coverage, when it may ... employer, or the employee's becoming entitled to Medicare benefits (under Part A, ...

www.bds-corp.com/wp-content/uploads/2014/10/COBRA-Election-or-Refusal-Form.doc

COBRA Election (or Refusal) Form. Date Employee Name. Address. On (date) your group coverage, including dependents, in the (employer name) group plan ...