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COBRA Continuation Coverage Election Notice - California Employees
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COBRA Continuation Coverage Election Notice - California Employees
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Item #
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FCB
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Your Price |
$6.99
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Availability
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Available
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Auto-Ship Option
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Description
Provide this form within 90 days of the commencement of COBRA coverage or first date of right to elect coverage. This form is required by both California and Federal law.
Provide this form to an employee or employee's spouse within 90 days of the commencement of Consolidated Omnibus Budget Reconciliation Act (COBRA) coverage or the first date at which the plan administrator is required to advise a qualified beneficiary of the right to elect coverage. Depending on your company’s plan, different options will apply.
- Easy to use, fill-in-the-blank format
- Downloadable, RTF file for you to personalize
Additional Information
This form is FREE for CalChamber members. Access it now on HRCalifornia. |
Provide this form within 90 days of the commencement of COBRA coverage or first date of right to elect coverage. This form is required by both California and Federal law.
Provide this form to an employee or employee's spouse within 90 days of the commencement of Consolidated Omnibus Budget Reconciliation Act (COBRA) coverage or the first date at which the plan administrator is required to advise a qualified beneficiary of the right to elect coverage. Depending on your company’s plan, different options will apply.
- Easy to use, fill-in-the-blank format
- Downloadable, RTF file for you to personalize
This form is FREE for CalChamber members. Access it now on HRCalifornia. |
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