How to use or fill out Illinois State Continuation Model Notice with our platform
- Click ‘Get Form’ to open the Illinois State Continuation Model Notice in the editor.
- Begin by entering the date of the notice at the top of the form. This is crucial for tracking deadlines.
- Identify and list the qualified beneficiary(ies) who are entitled to continuation coverage. Ensure all names are accurate.
- In the section regarding termination, check the appropriate box that indicates why coverage is ending, such as 'End of employment' or other qualifying events.
- Complete the Election Form by filling in details for each qualified beneficiary, including their name, date of birth, relationship to the employee, and SSN or identifier.
- Review all entered information for accuracy before submitting. Make sure to sign and date the form at the bottom.
- Submit your completed Election Form according to instructions provided on the document, ensuring it is sent within 30 days from this notice.
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