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Sample cobra letter to employees on company letterhead

Cobra letter example 2025

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This document is a COBRA letter informing employees and their dependents about their rights to continue group medical and dental coverage after certain qualifying events, such as termination of employment or reduction in hours. It outlines the duration of coverage extensions, conditions that may affect eligibility, notification requirements for continuation of coverage, associated costs, and options for converting to individual coverage. The letter emphasizes the importance of timely communication with the plan administrator.

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How do I get a COBRA termination letter?

When its time to stop or cancel your coverage, you would need to make a request from the plan administrator to receive a letter of notice of COBRA termination. Typically, the COBRA Administrator is in the HR department or is a third-party administrator.

How do I terminate my COBRA coverage?

There are three ways to do so: Terminate coverage on your online account. For instructions, see How to terminate coverage in your COBRA online account. Submit a completed COBRA Benefits Termination Form. Do not remit the premium payment for the month you no longer want coverage.

What does the COBRA stand for?

Cal-COBRA is a California Law that lets you keep your group health plan when your job ends or your hours are cut.

What is an example of benefits termination letter?

Benefits termination letter sample We regret to inform you that on [date], you will no longer be eligible for [coverage or benefit]. The reason for this termination of benefits is [dismissal/departure/change in service provider]. You can expect additional information to be sent by [communication method] by [date].

What is a COBRA letter?

If you are unable to obtain a new copy from your former employer, you can also contact the COBRA administrator for your health plan. They should have a record of your enrollment and may be able to provide you with a new copy of the paperwork. Act quickly, as there is a 60-day window of time to enroll in COBRA coverage.

cobra letter sample

COBRA letter to terminated employee Cobra letter example pdf Sample COBRA letter to employee Cobra letter example for employee COBRA initial notice requirements COBRA rights notice to new hires COBRA forms pdf COBRA specific rights notice

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How do you write a simple termination letter?

What to include in your employee termination letter Date of termination. Reason for termination. List of verbal and written warnings. Receipt of company property. Details of final pay and benefits. Termination due to poor performance. At-will termination letter.

How do I write a COBRA termination letter?

Required content and form The notice must explain the reason coverage has terminated, provide the date of termination and describe any rights the qualified beneficiary may have to elect alternative group or individual coverage, such as a conversion right (29 C.F.R. 2590.606-4(d)).

Cobra letter example 2025

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What is a COBRA letter?

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