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Send in which circumstances may the right to elect continued coverage under cobra exist for a covered spouse or dependent via email, link, or fax. You can also download it, export it or print it out.

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The Consolidated Omnibus Budget Reconciliation Act (COBRA) gives workers and their families who lose their health benefits the right to choose to continue group health benefits provided by their group health plan for limited periods of time under certain circumstances such as voluntary or involuntary job loss,
COBRA is always retroactive to the day after your employer coverage ends.
The following are qualifying events: the death of the covered employee; a covered employees termination of employment or reduction of the hours of employment; the covered employee becoming entitled to Medicare; divorce or legal separation from the covered employee; or a dependent child ceasing to be a dependent under
You have 60 days to enroll in COBRA once your employer-sponsored benefits end. Even if your enrollment is delayed, you will be covered by COBRA starting the day your prior coverage ended.
When Federal COBRA ends, eligible employees can buy 18 months additional health coverage under Cal-COBRA. All qualified beneficiaries are generally eligible for continuation coverage for 36 months after the date the qualified beneficiarys benefits would otherwise have terminated.
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COBRA applies to most private sector businesses with 20 or more employees. It requires an employers group health insurance plan to continue after qualifying life events. These include: Termination or a reduction of a covered employees hours.

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