Warning! Cookies must be enabled for proper operation of the website.
  • Order by Phone 1-800-333-3795
Welcome guests! | | Register
$0.00 (0 items in your cart)

Shop our products

Enter your email address

Employer Notice to COBRA Administrator Forms

Used to notify the health plan administrator that an employee has qualified for coverage

employer-notice-to-COBRA-administrator-form
Item Type SKU Qty Price
Pad of 25 EZ-412-P $9.95

COBRA regulations apply to businesses that sponsor a health plan for 20 or more employees and are not in compliance. Specifically, covered entities must provide a general notice of coverage at the time of enrollment and send additional notices (such as an election notice) when a qualifying event occurs that results in continuation of health coverage.

Our Employer Notice to COBRA Administrator Form can be used to notify the health plan administrator when an employee or dependent becomes eligible for COBRA extended coverage.

$9.95 InStock NewCondition

You May Also Need...

COBRA Notification PosterCOBRA Information Forms
COBRA-notification-poster-from-Personnel-ConceptsCOBRA-information-forms-from-Personnel-Concepts
$19.95$9.95
More InfoMore Info