How do I elect COBRA?

You will need to complete the form on page 7 of the election form in its entirety. Please include the date of birth and Social Security numbers for all dependents that are to be covered. Sign and date the form and return it to Chard Snyder for processing. You may elect one or all of the benefits under which you previously had coverage. In addition, you may elect the same amount of coverage as you received, or you may elect less coverage than you received, but you may not elect more coverage then you received as an active employee. All of this information is found on page 6 of the election form. Here are explanations for some of the terms:

Coverage Type: the plan under which you had coverage (Example: UHC-PPO)
Tier Type: the level of coverage you had or wish to elect (Example: EE+ Family)
Rate: the monthly premium amount for the coverage being elected

Still Have Questions?

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