Free Cobra Notice Template
Cobra Notice
[DATE]
[YOUR COMPANY NAME]
[YOUR COMPANY ADDRESS]
[YOUR COMPANY PHONE]
Dear [Recipients],
I hope this letter finds you well. I am writing to inform you about your rights to continue health insurance coverage under the Consolidated Omnibus Budget Reconciliation Act (COBRA).
As a former employee of Acme Corporation, you and your eligible dependents have the option to continue your group health insurance coverage under COBRA if you experience a qualifying event that results in the loss of coverage. Qualifying events may include termination of employment, reduction in hours, divorce or legal separation, or other events that cause you to lose eligibility for group health coverage.
By COBRA regulations, we are providing you with this notice to inform you of your rights and obligations under COBRA. You have the opportunity to elect COBRA continuation coverage within 60 days of receiving this notice. If you choose to elect COBRA coverage, you will be responsible for paying the full cost of the premiums, including any administrative fees.
Please review the enclosed COBRA Election Form for detailed information on how to elect COBRA coverage and the associated premium rates. If you have any questions or need assistance, please do not hesitate to contact our benefits administrator at 805-735-3872.
It's important to understand that failing to elect COBRA coverage within the specified timeframe may result in a loss of eligibility for continuation coverage. Therefore, we strongly encourage you to carefully review your options and make an informed decision regarding your health insurance coverage.
Thank you for your attention to this matter. We value your contributions during your employment with Acme Corporation and wish you all the best in your future endeavors.
Sincerely,
[Your Name]
