North Dakota Acknowledgment of Receipt of COBRA Notice

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State:
Multi-State
Control #:
US-502EM
Format:
Word
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Description

This Employment & Human Resources form covers the needs of employers of all sizes.

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FAQ

COBRA continuation coverage notices are documents that explain employees' rights under the Consolidated Omnibus Budget Reconciliation Act of 1985. These documents generally contain a variety of information, including the following: The name of the health insurance plan.

As COBRA is the same employer-sponsored you had previously, you would need to contact the COBRA Plan Administrator. If you are unsure you that is, contact the HR Department at the business who provided the group health plan.

Employers should send notices by first-class mail, obtain a certificate of mailing from the post office, and keep a log of letters sent. Certified mailing should be avoided, as a returned receipt with no delivery acceptance signature proves the participant did not receive the required notice.

In addition, employers can provide COBRA notices electronically (via email, text message, or through a website) during the Outbreak Period, if they reasonably believe that plan participants and beneficiaries have access to these electronic mediums.

COBRA (Consolidated Omnibus Budget Reconciliation Act of 1985) is a federal law that requires employers of 20 or more employees who offer health care benefits to offer the option of continuing this coverage to individuals who would otherwise lose their benefits due to termination of employment, reduction in hours or

If you need further information about COBRA, ACA, HIPAA, or ERISA, visit the Employee Benefits Security Administration's (EBSA) Website at dol.gov/ebsa/complianceassistance.html. Or you may contact EBSA electronically at askebsa.dol.gov or call toll free 1-866-444-3272.

In addition, employers can provide COBRA notices electronically (via email, text message, or through a website) during the Outbreak Period, if they reasonably believe that plan participants and beneficiaries have access to these electronic mediums.

To access the COBRA portal, click on the Login button in the upper right hand corner of the website, then click "Members" from the dropdown menu. From the Member Login page, click the "COBRA Login" button and you will be directed to the COBRA portal page.

The Consolidated Omnibus Budget Reconciliation Act (COBRA) gives workers and their families who lose their health benefits the right to choose to continue group health benefits provided by their group health plan for limited periods of time under certain circumstances such as voluntary or involuntary job loss,

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North Dakota Acknowledgment of Receipt of COBRA Notice