COBRA Coverage History Panel

Button Name Function Q.E. Type Select from the list of options the qualifying event which allows the employee the opportunity participate in the COBRA program. Q.E. Date Here you may enter the qualifying event date in MM/DD/YYYY format, which is the date which gave the employee the opportunity to participate in COBRA, occured. Notice Date This is the date in MM/DD/YYYY format which the notice informing the employee of their COBRA rights, was sent out. Election Exp. This is the date in MM/DD/YYYY format when the employee's opportunity to participate in the COBRA program expires. Election Rec. This is the date in MM/DD/YYYY format that the letter from the employee indication a decision in the affirmation to participate in COBRA was recieved. COBRA Eff. This is that date that COBRA coverage began to be effective, in MM/DD/YYYY format. COBRA End This is the date (if there is one) that COBRA coverage ended, in MM/DD/YYYY format. Normal Coverage End Date This is the date that coverage previous to COBRA coverage ended, in MM/DD/YYYY format. COBRA Notes Any other notes regarding COBRA coverage, that the operator wishes to attach to the employee may be specified here. The maximum size of the note is 99 characters.