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How to Obtain a COBRA Application

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    • 1). Find out the name and contact information of your employer's health plan administrator as soon as you are informed of a qualifying event. The human resources department usually administers the health plans. Events that qualify an employee for COBRA coverage include termination or a reduction in hours, or the individual becoming eligible for Medicare benefits under Title XVIII of the Social Security Act. A spouse or dependent qualifies for COBRA coverage in the event of the covered employee's death, divorce or legal separation from the covered employee, or when a dependent child is no longer a dependent.

    • 2). Notify the health plan's administrator that you want to receive a COBRA application within 30 days of the qualifying event. Request the administrator to confirm receipt of your notification, either via phone or in writing. Note that dependents have 60 days to notify a plan administrator of a qualifying event.

    • 3). Wait 14 days to receive the COBRA application, also referred to as an election notice.

    • 4). Check your mail regularly and notify the plan administrator if you haven't received your COBRA election notice within 14 days. By law, employers are required to send the COBRA application via first class mail or in person.

    • 5). Decide if you will elect to extend health insurance coverage through COBRA. You have 60 days to submit your election notice.

    • 6). Submit a claim for benefits according to the specific health plan's rules as explained in the summary plan description. After electing coverage, claimants have 45 days to pay the premium. As part of a stimulus bill passed by President Obama, the federal government will pay a subsidy of 65 percent of COBRA premiums for employees laid off between September 2008 and December 31, 2009. As of January 2010, the subsidy will extend for nine months and is subject to income eligibility.

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