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Summary of COBRA Notice Requirements
(Groups with 20 or more employees)

Notice for:

By/To:

Made:

New Plan: Notice of rights under COBRA

Plan Administrator to employees & spouse (required)

When the plan first comes under provisions of COBRA

New Plan Participant: Notice of rights under COBRA

Plan Administrator to new participants on the plan (required)

Within 90 days of when a new participant is first covered under the plan

Qualifying Event: Divorce, legal separation, loss of dependent child status

Employee to employer or Plan Administrator (required for eligibility)

Within 60 days of the qualifying event*

Qualifying Event:

Employer to plan Administrator (required)

Within 30 days from a termination, reduction in hours or death of an employee, the employer must notify the Plan Administrator

Qualifying Event: Eligibility for coverage, premiums and rights to elect

Plan Administrator to qualified beneficiary (required)

Where there is a qualifying event or notice of a qualifying event is received, the Plan Administrator must notify the qualified beneficiary of either his or her continuation coverage eligibility or unavailability within 14 days

COBRA Election: Election of COBRA continuation coverage

Qualified Beneficiary to employer (required for coverage)

Within 60 days of the later of termination of coverage or the date of eligibility notice from employer

First Payment: Payment and eligibility forms

Qualified Beneficiary to employer (required for coverage)

Within 45 days of date of election

Notice of Change: Plan changes, premium changes

Plan Administrator to qualified beneficiary (required)

When changes occur

Conversion Notice: Right by qualified beneficiary to convert (if conversion option available to similarly situated)

Plan Administrator to qualified beneficiary (required)

Within 180 days before the anticipated termination date or immediately upon termination, whichever comes first.

Notice of Termination: By qualified beneficiary from COBRA coverage

Qualified Beneficiary to employer (optional)

At or before termination

Notice of Any Termination: Of coverage prior to the stated duration of coverage

Plan Administrator to qualified beneficiary (required)

As soon as possible after termination

*There may be specific guidance in the plan for this notice

› Producer Bios

› How Health Care has changed
› Pre-Tax Premium Plans
› Beneficiary Forms
› Family Medical Leave Act
› The Importance of Employee Benefits
› Employee's Favor Health Care
› FYI COBRA
› COBRA Duration Periods
› COBRA Notice Requirements

› Disability Insurance Report
› Life Insurance Report

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