Cobra Payment Coupon Template

Qualified beneficiary s time to elect cobra. The university reserves the right to require future payment of cobra premiums by money orders or certified check due to a check returned because of insufficient funds first payment for cobra coverage if you elect cobra you do not have to send any payment with the election form. Cobra invoice free download cobra gunship cobra snipping tool free invoice template excel invoice form and many more programs.

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Cobra monthly payment coupon author.

Cobra payment coupon template. Mary jo drake created date. 45 days from the date cobra election is made. 3 7 2006 10 59 00 pm company. All cobra premiums must be paid by check or money order.

Qualified beneficiary s payment of initial premium. Visit the office template section of the microsoft website and click the option for coupons you can then download the template and enter information that you want to appear on each coupon including the date amount due coupon number your company name and the payer s name. 60 days from the later of the date coverage is lost or the date notice of cobra right and election form are sent. Solo last modified by.

Initial premium includes all premiums due up to the time of payment. Cobra payment coupons jan 3 2013 5 26 01 am a group health plan subject to federal cobra does not have to provide coverage to a qualified beneficiary until a timely election is made and required premiums are paid. Create payment coupon booklets using a template from microsoft word.