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Get and Sign Can I Elect Cobra Online Form 2006

Get and Sign Can I Elect Cobra Online Form 2006

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To us. If you do not elect COBRA continuation coverage, your coverage under the Plan will end at 12:01 AM on 1/31/2006 due to end of employment. If elected, COBRA continuation coverage will begin on 1/31/2006 and can last until 7/31/2007. You may elect any of the following options (note: monthy cost is shown to the right) for COBRA continuation coverage: Employee Medical Coverage Spouse Medical Coverage Child(ren) Medical Coverage 204.00 224.40 163.20 You do not have to send any payment with...
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