Maryland Election Form for Continuation of Benefits — COBRA: The Maryland Election Form for Continuation of Benefits — COBRA is a vital document that allows eligible individuals to elect the continuation of their health insurance coverage under the Consolidated Omnibus Budget Reconciliation Act (COBRA). COBRA ensures that employees and their dependents can maintain their health insurance benefits temporarily when their coverage would otherwise end due to certain qualifying events. This election form is specifically designed for residents of Maryland who are covered under group health plans sponsored by employers with 20 or more employees. It is imperative for employees and their dependents to understand their rights and obligations under COBRA and complete this form accurately and within the specified time frame to secure their continued access to critical healthcare benefits. By submitting the Maryland Election Form for Continuation of Benefits — COBRA, individuals have the option to continue the same health insurance coverage they had while they were employed, often for a limited period of time. This form serves as the official declaration of intent to carry on coverage and entails important information including the employee's personal details, the qualifying event, the health plan chosen for continuation, and the applicable premium-payment arrangement. Different types of Maryland Election Forms for Continuation of Benefits — COBRA may include: 1. Employee Election Form: This form is completed by the employee who experienced a qualifying event that triggered their eligibility for COBRA coverage. It allows them to select the health plan they wish to continue and outline their premium payment preferences. 2. Dependent Election Form: In cases where dependents (spouses, children, etc.) are covered under the employee's group health plan and experience a qualifying event, they may submit a Dependent Election Form to elect continuation of their benefits. This form typically requires basic personal information and details about the qualifying event. 3. Retroactive Enrollment Form: In certain situations, eligible individuals may experience a gap in coverage due to late notification or failure to initially elect COBRA continuation. The Retroactive Enrollment Form allows these individuals to retroactively enroll in COBRA and secure coverage for the period they missed, upon making the necessary premium payments. It is crucial for individuals facing qualifying events, such as termination of employment, divorce, or the loss of dependent status, to promptly complete the Maryland Election Form for Continuation of Benefits — COBRA. Failure to submit this form within the specified time frame may result in the loss of COBRA eligibility and potential gaps in health insurance coverage. Therefore, it is highly recommended to carefully read and follow the instructions provided along with the form to ensure successful continuation of benefits.