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COBRA Continuation Coverage Election Notice - California Employees
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Description |
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
If you know you will need this product every year and would like to avoid the hassle of reordering, please check the box to sign up for Auto-Ship. With Auto-Ship, we will automatically send you next year’s product when it becomes available. Please note that the prices of Auto-Ship items are subject to change. We will remind you of the products that you will be receiving as well as provide information regarding price changes prior to shipping the products. You can modify or cancel your Auto-Ship order any time before the item ships. If you do not wish to sign up for Auto-Ship please click Continue.
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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
Specifications
Related Files
Additional Information
This form is FREE for CalChamber members. Access it now on HRCalifornia. |
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Reviews
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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