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[DOC File]Benefits Termination Notice (Regular Employees)
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You may elect to continue your coverage with no change in rates or benefits. Please contact CNA directly 1-877-777-9072 to elect continuation of coverage. FLEXIBLE SPENDING ACCOUNTS. You coverage under both Health Care Spending and Dependent Care Spending accounts terminates on the last day of your employment.
end of benefits coverage letter

[DOC File]Sample Letter Employers Can Give to Employees
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Sample Letter Employers Can Give to Employees. We verified the following information with Social Security on this date: _____. Name _____ Social Security Number _____ According to Social Security, the information above does not match Social Security’s records. You should: Check to see if the information above matches the name and Social ...
loss of benefit coverage letter

[DOCX File]Model COBRA Continuation Coverage Election Notice
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Model COBRA Continuation Coverage Election Notice. Instructions. The Department of Labor has developed a model Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) continuation coverage election notice that the Plan may use to provide the election notice.
sample loss of coverage letter

[DOC File]FMLA LEAVE REQUEST COVER LETTER
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(For Leave for Family Member’s Serious Health Condition) [Date] [Employee Name] [Employee Address] Dear [Employee Name]: In response to your request for a leave of absence to care for a family member with a serious health condition, we are providing you with information pertaining to the University’s Family and Medical Leave (FML) policy.
health insurance coverage letter sample

[DOC File]CERTIFICATE OF GROUP HEALTH PLAN COVERAGE
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coverage, you may be able to get into another group health plan for which you are eligible (such as a spouse’s plan), even if the plan generally does not accept late enrollees, if you request ...
insurance coverage letter

[DOC File]MODEL COBRA CONTINUATION COVERAGE ELECTION NOTICE
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Failure to provide notice of a disability (including a copy of the Social Security determination letter) or second qualifying event may affect the right to extend the period of continuation of coverage. Disability. An 11-month extension of coverage may be available, beyond the original 18 months, if any of the qualified beneficiaries is disabled.
employee benefits coverage

[DOCX File]Model COBRA Continuation Coverage General Notice
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Model COBRA Continuation Coverage General Notice. Instructions. The Department of Labor has developed a model Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) continuation coverage general notice that plans may use to provide the general notice. ... Your spouse becomes entitled to Medicare benefits (under Part A, Part B, or both); or.
cover letter for employee benefits

[DOC File]Sample Letter—Subtitute Eligibility for Health Insurance ...
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Sample Letter—Subtitute Eligibility for Health Insurance Coverage Author: TASB HR Services Keywords: TRS, insurance, ACA, substitute Last modified by: maramirez Created Date: 12/4/2014 3:54:00 AM Company: TASB Other titles: Sample Letter—Subtitute Eligibility for Health Insurance Coverage
insurance coverage letter sample

[DOC File]Sample COBRA letter to employees on company letterhead
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Coverage for your eligible dependents can be extended up to 36 months if one of the following “qualifying events” occurs: They are covered under the plan(s) and you die while still employed. ... Sample COBRA letter to employees on company letterhead ...
end of benefits coverage letter

[DOC File]Letter from Employer to Employees - take care plans
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SAMPLE Letter Employer to Employees. Premium Only Plan (DATE) Enhancement to Your Company-Sponsored Health Insurance . To All XYZ Company Employees: If you are taking advantage of our company-sponsored group health insurance plan, currently you pay your portion of the premium with .
loss of benefit coverage letter

Benefits coverage letter sample