Cobra Insurance Application Form

Cobra Insurance Application Form. If you decide to keep cobra without premium assistance, you can qualify for a special enrollment period based on the end date of your cobra coverage, which is usually 18 to 36 months after it started. Prior to ending state employment you were enrolled in the state health plan ppo.

Cobra Election Form For Employee To Sign Fill Online, Printable from www.pdffiller.com

Get everything done in minutes. Your cobra coverage should be the same insurance that you had with your past employer. The same is true for dental.