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The document is a COBRA election form from Health Net Health Plan of Oregon, Inc., allowing individuals to elect continuation coverage after losing health insurance due to qualifying events. It outlines the process for completing the form, eligibility criteria, and options for coverage duration. The form requires personal information, details about dependents, and includes a section for the individual to indicate their choice regarding COBRA coverage.

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2010	4.8 Satisfied (48 Votes)

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What is a COBRA form?

There is a statutory penalty for late COBRA notices to former employees of $110 per day (after the 14 or 30 (44) days as previously posted). However, there have been court decisions denying the penalty if the former employee is not harmed (doesnt elect, or has no gap in coverage), or the employer acted in bad faith.

What happens if I dont get COBRA paperwork?

You have 60 days to enroll in COBRA once your employer-sponsored benefits end. Even if your enrollment is delayed, you will be covered by COBRA starting the day your prior coverage ended.

What is COBRA and how does it work?

COBRA, the Consolidated Omnibus Budget Reconciliation Act, lets qualified workers keep their group health insurance for a limited time after a change in eligibility.

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