Forms Used to Work with COBRA Coverage for Participants

Form Name

Form ID

Navigation

Usage

Work With COBRA Coverage Selection

W08921A

Daily Processing (G05BCOB2), Coverage Selection

Review COBRA participants.

COBRA Coverage Selection

W08921C

On Work With COBRA Coverage Selection, complete the Participant Address field, and then click Find.

To waive COBRA coverage for this participant, click Waive COBRA Coverage

To select COBRA coverage for a participant, select a record, and then select Coverage Selection from the Row menu.

Waive or select COBRA coverage for a participant.

COBRA Coverage Revisions

W08922C

Periodic Processing (G05BCOB3), Coverage Review

On the Work With Elected COBRA Coverage form, find a record and then click Select.

Review or revise COBRA coverage for a participant.

COBRA Coverage Selection

W08921C

Daily Processing (G05BCOB2), Coverage Selection

On Work With COBRA Coverage Selection, complete the Participant Address field, and then click Find.

Select a record and click Select.

Terminate COBRA coverage for a participant.