The COBRA Rights Notification Letter Template contains a model form of the letter that all employees must receive either from their employer or from the benefit plan administrator of their benefit plans. If your business has 20 or more employees and offers health, disability, dental, or vision benefits, you are required to provide employees with a notice explaining their rights under COBRA. (Note: Employees are not entitled to group-term life insurance coverage provided by you once they terminate employment)

Federal law requires that certain information about COBRA be provided to employees and their spouses and dependents at the time the employee is hired. If you must comply with COBRA law, the following letter can be used to comply with the initial notice requirement portion of the law. This letter should be sent when an employee is hired. Make sure to document your compliance with the requirement by keeping a copy of the letter in the personnel file or by sending it certified mail with a return receipt requested.

The file contains a Department of Labor approved document that is suitable for use with most word processing programs used in the Windows environment. 

Special Features:

Included are the following:

  • a ready-made letter that requires that you fill in the blanks with your employee's name and address, the name of the insurance plan/company, and the name of the plan administrator
  • special headings and organization to help your employees understand their rights to continue insurance coverage in the event they should leave or be terminated
  • helpful checklists to help you and your employees know when COBRA coverage is warranted
  • clear directions about what employees can expect and what they must do should they wish to take advantage of COBRA coverage in the future
Toolkit is providing these tools free of charge. Some of these forms contain technical language and create significant legal obligations. Do not use any form without first having an attorney review the form and determine that it is suitable for the purpose for which you intend it.
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