Ct notice 2026

1. Click ‘Get Form’ to open the ct notice in the editor.
2. Begin by entering the date of the notice at the top of the form. This is crucial for tracking your election period.
3. Fill in your name and the names of any qualified beneficiaries in the designated fields. Ensure accuracy to avoid processing issues.
4. Indicate the reason for coverage termination by checking the appropriate box, such as 'End of employment' or 'Divorce.'
5. Select which qualifying beneficiaries are entitled to continuation coverage by checking their respective boxes.
6. Complete the Election Form section by providing necessary details like name, date of birth, relationship to employee, and social security number.
7. Sign and date the form at the bottom before submitting it according to instructions provided.

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