Employer Notice to COBRA Administrator Forms

EZ-412-P
$9.95 / EA
Quantity Pricing
1 $9.95
10 $8.95 Save 10 %
25 $6.95 Save 30 %
50 $5.95 Save 40 %
100 $4.95 Save 50 %
Out of Stock

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.