Form CALHR689 Cobra Continuation Election Form - Flexelect Program - California

Form CALHR689 Cobra Continuation Election Form - Flexelect Program - California

What Is Form CALHR689?

This is a legal form that was released by the California Department of Human Resources - a government authority operating within California. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is CALHR689 Cobra Continuation Election Form?
A: CALHR689 Cobra Continuation Election Form is a form used in the Flexelect Program in California for electing Cobra continuation coverage.

Q: What is the Flexelect Program in California?
A: The Flexelect Program in California is a flexible benefits program that allows eligible state employees to customize their benefit plans.

Q: What is Cobra continuation coverage?
A: Cobra continuation coverage is a temporary extension of health insurance coverage for eligible individuals who lose their job or have a reduction in work hours.

Q: What is the purpose of CALHR689 Cobra Continuation Election Form?
A: The purpose of CALHR689 Cobra Continuation Election Form is to allow eligible state employees to elect Cobra continuation coverage under the Flexelect Program.

Q: Who can use CALHR689 Cobra Continuation Election Form?
A: CALHR689 Cobra Continuation Election Form can be used by eligible state employees who are enrolled in the Flexelect Program and need to elect Cobra continuation coverage.

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Form Details:

  • Released on July 1, 2016;
  • The latest edition provided by the California Department of Human Resources;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form CALHR689 by clicking the link below or browse more documents and templates provided by the California Department of Human Resources.

Download Form CALHR689 Cobra Continuation Election Form - Flexelect Program - California

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