Paychex cobra 2025

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The COBRA Employee Datasheet is a form used to document and process the loss of health insurance coverage for employees and their dependents due to qualifying events. It requires detailed information about the individuals affected, the nature of the qualifying event, and the insurance plans involved. The completed form must be submitted to Paychex within 30 days to ensure continuation of coverage.

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Click ‘Get Form’ to open the paychex cobra document in the editor.
Begin by entering the COMPANY/CLIENT NAME and OFFICE/CLIENT ACCT. # at the top of the form.
List any individuals being removed from insurance under 'Employee & Dependent Name(s)', including their Gender, Birthdate, and Address.
Indicate Medical Enrollment and Tobacco Use for each individual listed by selecting 'YES' or 'NO'.
Fill in the EMPLOYEE TELEPHONE # and DEPENDENT TELEPHONE # if different. Then, specify the Date of Qualifying Event.
Select the qualifying event that caused loss of coverage eligibility from the provided options.
Complete the COBRA Insurance section by listing plans currently enrolled in and filling out requested information.
Finally, provide your AUTHORIZED COBRA CONTACT SIGNATURE and DATE before submitting the completed form to Paychex via email, fax, or mail.

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We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

Does Paychex do COBRA?

COBRA/Continuation Coverage Thats Easy to Manage and Maintain. Get COBRA solutions, support, and expertise from Paychex and avoid the hassle of in-house COBRA administration so you can stay focused on other priority business initiatives.

Does COBRA coverage begin immediately?

The average monthly cost of COBRA Insurance premiums ranges from $400 to $700 per individual.

Does COBRA start the day you quit?

COBRA coverage timeline For example, if employment ends on April 25, COBRA will pick up where the group health plan ends. If it ends immediately, COBRA eligibility begins on April 26. If the benefits stop at the end of the month, as with many employers, COBRA coverage begins May 1.

How long does it take for COBRA benefits to kick in?

Assuming one pays all required premiums, COBRA coverage starts on the date of the qualifying event, and the length of the period of COBRA coverage will depend on the type of qualifying event which caused the qualified beneficiary to lose group health plan coverage.

How does an employee pay for COBRA?

If you get COBRA, you must pay for the entire premium, including any portion that your employer may have paid in the past. This means your payment is often more expensive than what you paid as an employee. You can collect COBRA benefits for up to 18 months. This may be extended to 36 months under certain circumstances.

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