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Model COBRA Continuation Coverage Election Notice
ICR 202103-1210-002 · OMB 1210-0167 · Object 110621601.
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Document Metadata
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
|---|---|
| File Title | Model COBRA Continuation Coverage Election Notice |
| Subject | Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) |
| Author | Employee Benefits Security Administration |
| File Created | 2021-04-07 |
| Conversion State | partial |