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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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Does COBRA automatically start?

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.

What is a continuation of coverage?

Continuation coverage allows someone who recently lost their employer-based health coverage to continue their current insurance policy as long as they pay the full monthly premiums.

How long can you stay on COBRA in Illinois?

Under COBRA, an individual may be entitled to up to 18 months, 29 months, or 36 months of continuation coverage depending upon which qualifying event(s) triggered the COBRA coverage. The following table illustrates the maximum coverage periods for each qualifying event.

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How long is state continuation in Illinois?

In general, the maximum period of coverage under Illinois Continuation (mini-COBRA) is twelve (12) months after the date the insurance stopped because your employment was terminated or your hours were reduced below the minimum required by the group plan.

Does Illinois have state continuation?

What is the Illinois Continuation (mini-COBRA) Law? The Illinois Continuation Law protects individuals who lose their group health insurance coverage with an employer group of any size due to termination of employment or reduction in hours below the minimum required by the group plan.

Why would I get a certified letter from COBRA?

The purpose of this letter is to inform you of your rights and responsibilities as a plan participant. Qualifying Event: At the end of your employment or because of reduction of hours (not maintain full-time status) you will receive this letter.

How long is COBRA coverage in Illinois?

Under COBRA, an individual may be entitled to up to 18 months, 29 months, or 36 months of continuation coverage depending upon which qualifying event(s) triggered the COBRA coverage. The following table illustrates the maximum coverage periods for each qualifying event.

How long keep COBRA notices?

Keep Your Health Coverage (COBRA) Small Employer (2 to 19 employees)Large Employer (20 or more employees)Cal-COBRA \u2014 up to 36 monthsFederal COBRA \u2014 18 or 36 months. For more information visit the Department of Labor website . Cal-COBRA \u2014 If Federal COBRA was 18 months, 18 more months of Cal-COBRA is available

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