Form A10386 Extended Coverage / Cobra Change Request - Virginia

Form A10386 Extended Coverage / Cobra Change Request - Virginia

What Is Form A10386?

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

FAQ

Q: What is Form A10386?
A: Form A10386 is an Extended Coverage/Cobra Change Request form.

Q: What is Extended Coverage?
A: Extended Coverage refers to the continuation of health insurance coverage after a qualifying event.

Q: What is COBRA?
A: COBRA stands for the Consolidated Omnibus Budget Reconciliation Act, which gives employees the right to continue their health insurance coverage after leaving a job or experiencing a qualifying event.

Q: Who needs to fill out Form A10386?
A: Employees or their eligible dependents who want to request extended coverage or COBRA coverage need to fill out Form A10386.

Q: How do I fill out Form A10386?
A: You need to provide your personal information, the reason for the extended coverage or COBRA request, and any supporting documentation if required.

Q: What happens after I submit Form A10386?
A: Your request for extended coverage or COBRA will be reviewed, and you will be notified of the decision and any further steps to take.

Q: What is a qualifying event?
A: A qualifying event could be the loss of a job, divorce, death of a covered employee, or aging out of dependent coverage.

Q: How long does extended coverage or COBRA last?
A: The length of extended coverage or COBRA varies depending on the qualifying event, but it typically lasts for 18 months to 36 months.

Q: Can I continue my health insurance coverage if I'm eligible for Medicare?
A: If you are eligible for Medicare, you may not be eligible for extended coverage or COBRA. However, you should consult with your employer or health insurance provider to understand your options.

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Form Details:

  • Released on March 1, 2019;
  • The latest edition provided by the Virginia Department of Human Resource Management;
  • 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 printable version of Form A10386 by clicking the link below or browse more documents and templates provided by the Virginia Department of Human Resource Management.

Download Form A10386 Extended Coverage / Cobra Change Request - Virginia

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