COBRA Election Notice

Entity Mandating Notice: Department of Labor's Employee Benefits Security Administration (EBSA).

Applicability: The Consolidated Omnibus Budget Reconciliation Act (COBRA) applies to employers with 20 or more employees. If the employer is the group health plan administrator, then it must provide this notice to qualified beneficiaries within 44 days of a qualifying event. Otherwise, the employer must notify the plan administrator within 30 days of a qualifying event, and the plan administrator must provide the notice to qualified beneficiaries within 14 days.

Obtaining this Notice: An employer may download this notice in English and Spanish directly from the EBSA website.

Additional Resources

Department of Labor

Employee Benefits Security Administration