Model Cobra Continuation Coverage Election Notice (Page 2 of 8) in pdf

Model Cobra Continuation Coverage Election Notice Page 2

There may be other coverage options for you and your family. When key parts of the health care

law take effect, you’ll be able to buy coverage through the Health Insurance Marketplace. In the

Marketplace, you could be eligible for a new kind of tax credit that lowers your monthly

premiums right away, and you can see what your premium, deductibles, and out-of-pocket costs

will be before you make a decision to enroll. Being eligible for COBRA does not limit your

eligibility for coverage for a tax credit through the Marketplace. Additionally, you may qualify

for a special enrollment opportunity for another group health plan for which you are eligible

(such as a spouse’s plan), even if the plan generally does not accept late enrollees, if you request

enrollment within 30 days.

If you have any questions about your rights to COBRA continuation coverage, you should

contact [enter name of party responsible for COBRA administration for the Plan, with telephone

number and address].

Model Cobra Continuation Coverage Election Notice Page 2