Forms

COBRA/MD Continuation Election Forms

COBRA COVERAGE CONTINUATION PERIODS
CONSOLIDATED OMNIBUS BUDGET RECONCILIATION ACT
INITIAL COBRA NOTICE
INITIAL COBRA NOTICE WO FSA
EMPLOYEE NOTICE OF QUALIFYING EVENT
COBRA ELECTION FORM
SAMPLE NOTICE OF UNAVAILABILITY
SAMPLE NOTICE OF TERMINATION
INITIAL HIPAA NOTICE
CERTIFICATE OF GROUP HEALTH PLAN COVERAGE
NOTICE OF HEALTH INFORMATION PRIVACY PRACTICES
NOTICE OF HEALTH INFORMATION PRIVACY PRACTICES
MARYLAND CONTINUATION COVERAGE NOTICE
MARYLAND STATE COVERAGE SAMPLE LETTER TO EMPLOYEE
MARYLAND CONTINUATION ELECTION FORM
NOTICE OF SPECIAL HIPAA ENROLLMENT RULES
HIPAA NOTICE OF PRE-EXISTING CONDITION EXCLUSION