The Kentucky Election Form for Continuation of Benefits, commonly referred to as COBRA, is a crucial document that allows individuals to maintain their health insurance coverage when faced with job loss or other qualifying events. This form serves as a formal request to continue receiving benefits under the Consolidated Omnibus Budget Reconciliation Act (COBRA), a federal law that ensures employees have access to health insurance even after leaving their job. Kentucky offers various types of Election Forms for Continuation of Benefits — COBRA, depending on the specific circumstances that trigger the need for coverage continuation. These forms include: 1. Kentucky Election Form for Continuation of Benefits due to Job Loss: This form is used when an individual loses their job and wishes to continue their health insurance coverage under COBRA provisions. This could result from a layoff, termination, or reduction in work hours. 2. Kentucky Election Form for Continuation of Benefits due to Divorce or Legal Separation: In situations where a divorce or legal separation occurs and the dependent spouse loses health insurance coverage, this form would be utilized to continue benefits under COBRA. 3. Kentucky Election Form for Continuation of Benefits due to Death of Employee: When the primary insured individual passes away, this form allows eligible dependents to maintain healthcare coverage through COBRA. 4. Kentucky Election Form for Continuation of Benefits due to Parental Coverage Loss: This document is utilized when dependent children reach the age limit for coverage under their parent's health insurance plan or become ineligible due to another qualifying event. It allows them to continue coverage under COBRA. 5. Kentucky Election Form for Continuation of Benefits due to Disability: If an individual becomes disabled and, as a result, loses their employer-provided health insurance, this form can be used to request COBRA continuation of benefits. It is important to note that each specific Election Form for Continuation of Benefits requires accurate and detailed information regarding the individual's personal details, the qualifying event triggering the need for COBRA, and any dependent information if applicable. Failure to submit a completed and signed form within the required timeframe may result in the loss of COBRA coverage. In conclusion, the Kentucky Election Form for Continuation of Benefits — COBRA is a crucial document that grants individuals the ability to maintain their health insurance coverage in various situations. Correctly completing and submitting the appropriate form is vital to ensuring uninterrupted access to vital healthcare services.