№ files_lp_4_process_3_112984
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Official model notice describing rights and procedures for electing continuation of employer-sponsored health coverage under federal COBRA law after events that would otherwise end coverage.
Year:
1985
Country:
United States
Subject:
Health insurance continuation rights
Document type:
Official notice template
Law / legal basis:
Consolidated Omnibus Budget Reconciliation Act (COBRA)
Responsible institution:
U.S. Department of Labor
Administrative office:
Office of Management and Budget (OMB)
Applicable plans:
Single-employer group health plans
Target audience:
Employees, former employees, spouses, and dependent children covered by employer health plans
Control number:
OMB Control Number 1210-0123
Related legislation:
Paperwork Reduction Act of 1995
Coverage subject:
Continuation of employer-sponsored health care coverage after qualifying events
Qualifying events:
End of employment, reduction in hours, death of employee, divorce or legal separation, entitlement to Medicare, loss of dependent child status
Coverage alternatives mentioned:
Health Insurance Marketplace, Medicaid, Medicare, other group health plans
Administrative contact:
U.S. Department of Labor, Office of Policy and Research, Washington, DC
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Year:
2019
Region / City:
United States
Topic:
Pension Plan Actuarial Reporting
Document Type:
Form
Agency:
Department of the Treasury, Internal Revenue Service, Employee Benefits Security Administration, Pension Benefit Guaranty Corporation
Author:
Unknown
Target Audience:
Actuaries, Pension Plan Administrators, Legal and Financial Professionals
Period of Validity:
2019
Approval Date:
Not provided
Date of Amendments:
Not provided
Plan Type:
Single Employer Defined Benefit Plan
Plan Size:
More than 500 participants
Funding Target:
Available for participants and beneficiaries
Effective Interest Rate:
123.12%
Liquidity Shortfall:
Not provided
Year:
1985
Jurisdiction:
United States
Topic:
Employee Health Benefits / COBRA Continuation Coverage
Document Type:
Official Guidance / Model Notice
Issuing Authority:
U.S. Department of Labor, Employee Benefits Security Administration
Audience:
Employees and their dependents affected by qualifying events
Legal Reference:
Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA)
Effective Period:
Upon qualifying event and election period
OMB Control Number:
1210-0123
Instructions Included:
Yes
Related Resources:
Health Insurance Marketplace, Medicaid, Medicare
Year:
1985
Region / city:
United States
Topic:
COBRA continuation coverage
Document type:
Notice
Organization / institution:
U.S. Department of Labor
Author:
U.S. Department of Labor
Target audience:
Employees, former employees, and their families
Effective period:
Until the date of coverage termination
Approval date:
Not specified
Date of revisions:
Not specified
Year:
2021
Region / City:
United States
Theme:
COBRA Premium Assistance, American Rescue Plan
Document Type:
Government Legislation Summary
Agency / Institution:
Department of Labor
Author:
Not specified
Target Audience:
Individuals eligible for COBRA, Employers, Plan Administrators
Effective Period:
April 1, 2021 – September 30, 2021
Approval Date:
March 11, 2021
Amendment Date:
Not specified
Year:
2021
Region / City:
California
Topic:
Open Enrollment, Health Benefits, Employee Benefits
Document Type:
Memorandum
Issuing Organization:
California Department of Fish and Wildlife (CDFW)
Author:
Human Resources Branch
Target Audience:
CDFW Employees
Effective Period:
September 20, 2021 - October 15, 2021
Approval Date:
September 17, 2021
Changes Date:
N/A
Deadline for Changes:
October 15, 2021
Contact Information:
AskHR Ticketing System
Related Forms:
Dental Enrollment Form STD692, Non-CoBen Cash Option Form STD701C, Flex Elect Reimbursement Form STD701R, CoBen Cash Enrollment Form STD702
Supplementary Resources:
What’s Changing for 2022, 2022 Plan Information, Benefits Calculator, Open Enrollment Reminders
Year:
2023
Revision:
2034
Region / city:
N/A
Theme:
COBRA & Direct Billing system import specification
Document type:
Technical specification
Organization / institution:
N/A
Author:
N/A
Target audience:
System administrators, database developers
Period of validity:
N/A
Approval date:
N/A
Date of changes:
February 11, 2023
Year:
1985
Jurisdiction:
United States
Topic:
Employee Health Benefits / COBRA Continuation Coverage
Document Type:
Official Guidance / Model Notice
Issuing Authority:
U.S. Department of Labor, Employee Benefits Security Administration
Audience:
Employees and their dependents affected by qualifying events
Legal Reference:
Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA)
Effective Period:
Upon qualifying event and election period
OMB Control Number:
1210-0123
Instructions Included:
Yes
Related Resources:
Health Insurance Marketplace, Medicaid, Medicare
Organization:
Chard Snyder
Role of organization:
Billing administrator for retiree and COBRA premium payments
Associated institutions:
OSU/A&M; NEO
Document type:
Frequently Asked Questions (FAQ)
Subject:
COBRA continuation coverage, Flexible Spending Accounts, Medicare enrollment, and Medicare Supplement insurance
Applicable groups:
Active employees, retired employees, COBRA enrollees, and covered spouses
Benefits discussed:
COBRA continuation coverage; retiree health benefits; Flexible Spending Account (FSA); Medicare Parts A, B, C, and D; Medicare Supplement (Medigap)
Legal framework referenced:
Consolidated Omnibus Budget Reconciliation Act (COBRA)
Geographic scope:
United States
Administrative responsibility:
Collection of premium payments for retiree and COBRA benefits
Eligibility notes:
Retirees enroll in retiree benefits rather than COBRA; retirees and covered spouses must enroll in Medicare Part B at age 65 under NEO policy
Processes described:
COBRA notification to departing employees; FSA claim submission deadlines after employment separation; Medicare enrollment timing and payment procedures
Year:
2025
Region / City:
Doncaster
Subject:
Early Years Inclusion Funding for SEND children
Document Type:
Guidance
Organization:
Doncaster Local Authority
Author:
Doncaster Council
Target Audience:
Schools and early years providers in Doncaster
Period of Validity:
Autumn Term 2025
Approval Date:
Not specified
Date of Changes:
Not specified
Note:
Year
Subject:
Medicaid
Document Type:
Notice
Organization:
NCF/DHB
Target Audience:
Caseworkers, County Staff
Context:
This document provides guidance on generating, handling, and updating the DSS-8110 Notice of Modification, Termination, or Continuation of Public Assistance in the NC FAST system.
Agency:
New Jersey Department of Human Services
Division:
Division of Developmental Disabilities
Jurisdiction:
New Jersey
Document type:
Administrative justification form
Service:
DDD-funded Prevocational Training
Purpose:
Annual justification for continuation beyond two-year limit
Intended users:
Support Coordinators and service providers
Approval authority:
Division of Developmental Disabilities
Related programs:
Individualized Service Plan, Prevocational Training
Associated systems:
iRecord
Submission requirements:
Supporting documentation upload and email review request
Review outcome options:
Approved or Denied
Validity period:
Annual continuation if approved
Year:
1985
Region / city:
United States
Topic:
COBRA continuation coverage
Document type:
Notice
Organization / institution:
U.S. Department of Labor
Author:
U.S. Department of Labor
Target audience:
Employees, former employees, and their families
Effective period:
Until the date of coverage termination
Approval date:
Not specified
Date of revisions:
Not specified
Year:
2025
Region / City:
Arizona
Theme:
School Safety Program
Document Type:
Grant Application
Organ / Institution:
Arizona Department of Education
Author:
Arizona Department of Education
Target Audience:
Arizona public schools and charter schools currently funded under specific grants
Effective Period:
FY 2025
Approval Date:
March 01, 2024
Amendment Date:
May 03, 2024
Note:
Year
Document type:
Application form
Purpose:
Individual license renewal or continuation
Regulatory field:
Insurance licensing
Geographic scope:
United States
Applicant category:
Resident and non-resident license holders
Issuing framework:
State insurance departments
Identification systems referenced:
National Producer Number (NPN), FINRA CRD
Legal references:
18 USC 1033
Information categories:
Personal data, business affiliations, background disclosures
Compliance areas:
Criminal history, administrative actions, child support obligations
Standardized source:
NAIC / NIPR application framework
Year:
2025
Region / City:
Canada
Subject:
Proposals to improve the Conference Preparatory Meeting Process
Document Type:
Report
Organization / Institution:
Radiocommunication Advisory Group (RAG)
Author:
Canada
Target Audience:
RAG members, ITU participants
Period of Validity:
Ongoing
Approval Date:
31 March 2025
Date of Changes:
None
Note:
Year
Year:
2026
Region / city:
Wisconsin, USA
Subject:
Group Home Licensing
Document type:
Checklist / Application Supplement
Agency:
Department of Children and Families (DCF)
Forms referenced:
DCF-F-5013, DCF-F-2978, DCF-F-5207, DCF-F-CFS2378, DCF-F-CFS0909, DCF-F-4148, DCF-F-CFS0367, DCF-F-CFS0358, DCF-F-5023, DCF-F-5129, DCF-F-5475-E
Audience:
Prospective group home license applicants
Instructions:
Submission of supporting documentation and fees via PIE website or electronic payment
Requirements:
Annual inspections, policy documents, floor plans, insurance verification, board or LLC member lists
Context:
Administrative checklist for applicants seeking to continue group home licensing and QRTP certification in Wisconsin, including required forms, inspections, and documentation verification
Note:
Year
Document type:
Form
Target audience:
Students, Tutors, Employers, Educational Institutions