COBRA Termination Letter

• SHARE
• 
• 
• 

The Consolidated Omnibus Budget Reconciliation Act of 1986 (COBRA) allows employees who lose their job to continue their employer sponsored group health insurance coverage for up to 30 months. This coverage can be terminated for a number of reasons including a failure to pay premiums, fraud, and eligibility under part A of part B of Medicare. According to Department of Labor DOL requirements, plan administrators must provide beneficiaries with a written notice of early termination of COBRA coverage, or a COBRA termination letter This allows the individuals to seek new health coverage or to file an appeal with the plan administrator.

Format and Content

A COBRA letter is drafted by the plan administrator with a copy mailed to each qualified beneficiary before the coverage is terminated. The COBRA termination letter format must include the reason why the coverageis being terminated, the rights of the beneficiaries, and the specific date the coverage will end. The letter is customized to fit theD particular plan offered by the company as well as particulars related to the employee. OL regulations require the letter to “be written in a manner calculated to be understood by the average plan participant.”

Sample

The person addressed in this COBRA termination letter sample is losing his health coverage due to a failure to pay his premiums on time. He is given notice of his right to appeal as well as the conditions of the appeal. He is asked to direct his questions to the plan administrator.