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The document is a COBRA Coverage Election Form for eligible employees who have experienced termination or a reduction in hours of employment. It outlines the rights to continue health care coverage under a specified group health plan, the process for electing COBRA continuation coverage, payment obligations, and eligibility criteria for qualified beneficiaries. The form must be completed and submitted to the Plan Administrator, with specific instructions regarding premium payments and notification requirements.

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Do I get a 1095 for COBRA?

If you had job-based health coverage. Depending on the kind of job-based coverage you had (including COBRA or retiree coverage), you may get one of these from your employer or insurance company: Form 1095-B, Health Coverage. Form 1095-C, Employer-Provided Health Insurance Offer and Coverage.

Who sends out COBRA paperwork?

There is a statutory penalty for late COBRA notices to former employees of $110 per day (after the 14 or 30 (44) days as previously posted). However, there have been court decisions denying the penalty if the former employee is not harmed (doesnt elect, or has no gap in coverage), or the employer acted in bad faith.

How do I get my COBRA letter?

You should receive your COBRA paperwork in the mail a few weeks or so after you leave your employer. If it doesnt show up by then, I would contact your former employer to check the status.

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