Dear ,
In accordance with the Consolidated Omnibus Budget Reconciliation Act (COBRA), is required to notify you of your rights to continue group health coverage following a qualifying event. This letter serves as your official COBRA notification.
The qualifying event applicable to you is: . As a result of this event, your current group health coverage through is scheduled to end on . Under COBRA, you have the right to elect continuation of your health coverage for a limited period.
To elect COBRA continuation coverage, you must complete and submit the enclosed election form on or before . This is a critical deadline, and failure to respond by this date will result in the permanent loss of your right to COBRA coverage. The monthly premium for continuation coverage is , which you will be responsible for paying in full.
Please carefully review all enclosed documentation, including the COBRA election form, plan details, and payment instructions. For questions or assistance regarding your COBRA rights and options, please contact the Human Resources department at .
Sincerely,
A COBRA notification letter is a legally mandated communication under the United States Consolidated Omnibus Budget Reconciliation Act that informs eligible employees and their dependents of their right to continue group health insurance coverage after a qualifying event such as termination, layoff, or reduction in hours. The notice must explain coverage options, costs, enrollment deadlines, and the duration of continued coverage. Employers with 20 or more employees are required to provide this notification.
Issuing COBRA notifications is a federal compliance requirement, and failure to do so can result in significant penalties including excise taxes and exposure to lawsuits from affected individuals. The notification ensures employees and their dependents are aware of their rights to continue health coverage during a vulnerable transition period. Proper and timely issuance protects the employer from claims of non-compliance and potential litigation.
The letter must identify the qualifying event, the individuals eligible for continuation coverage, the available coverage options, the premium amount and who pays it, and the 60-day election period. It should explain how to enroll, the duration of COBRA coverage (typically 18 or 36 months depending on the qualifying event), and the circumstances that would end COBRA coverage early. Contact information for the plan administrator must also be included.
Hyring's free COBRA notification letter generator helps HR teams produce compliant, comprehensive notices in minutes. Enter the qualifying event details, eligible individuals, coverage options, and premium information, and the tool generates a letter that follows federal notification requirements. Download the letter as a PDF for mailing to the qualifying beneficiaries within the required 14-day employer notification window.