COBRA Election Notice

A written notice of continuation coverage rights that must be sent to every qualified beneficiary after a qualifying event causes loss of group health coverage.

See the Step-by-Step ProcessView Model Notice
Worth knowing before you start: Unlike the General Notice, the Election Notice is event-driven: it must go out within a strict window every time someone loses coverage. You need to correctly identify every qualified beneficiary (not just the employee), hit the deadline from a specific triggering date, and accurately describe coverage options and costs. One missed beneficiary or a late notice can result in significant penalties. This is one area where a COBRA TPA often earns its fee.

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Administering COBRA means multiple required notices, strict deadlines, and real penalties if something is missed, so many employers hand it to a third-party administrator. ABY can take COBRA administration off your plate.

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What Written notice of COBRA continuation rights, delivered to all qualified beneficiaries after a qualifying event causes loss of group health coverage.
Who Employers with 20 or more employees that sponsor group health plans. The notice goes to employees, spouses, and dependent children losing coverage.
When Within 14 days of the plan administrator being notified of the qualifying event, or within 44 days of the qualifying event if the employer is the plan administrator.
Risk IRS excise tax of $100 per day per qualified beneficiary under IRC §4980B ($200/day when multiple family members are affected by the same qualifying event), plus up to $110 per day per qualified beneficiary in court-assessed ERISA §502(c)(1) penalties. Employers may also face lawsuits and liability for the beneficiary's uncovered medical claims.
44
Days when you self-administer

If the employer is its own plan administrator, one combined window of 44 days from the qualifying event covers both learning of the event and sending the notice.

14
Days for the administrator to send

When a TPA or insurer is the plan administrator, it has 14 days to send the notice after being notified of the event.

60
Days for beneficiary-triggered events

For events like divorce or a dependent aging out, the beneficiary has 60 days to notify the plan before the administrator's 14-day clock starts.

Scenario Deadline Notes
Employer is plan administrator, employer-triggered event (termination, reduction in hours, death, Medicare entitlement) Within 44 days of qualifying event Employer both learns of the event and sends the notice; the 44-day window covers both steps.
TPA or insurer is plan administrator, employer-triggered event Employer notifies administrator within 30 days; administrator then has 14 days to send notice Combined maximum: 44 days from qualifying event.
Beneficiary-triggered event (divorce, legal separation, dependent losing status, disability determination) Beneficiary has 60 days to notify plan administrator; administrator then has 14 days to send notice The clock runs from the plan administrator's receipt of notice, not from the qualifying event itself. If the beneficiary never notifies, the obligation may not be triggered.
Scenario: Employer is plan administrator, employer-triggered event
Deadline: Within 44 days of the qualifying event
Notes: One window covers learning of the event and sending the notice.
Scenario: TPA or insurer is plan administrator, employer-triggered event
Deadline: Employer notifies within 30 days; administrator then has 14 days
Notes: Combined maximum is 44 days from the qualifying event.
Scenario: Beneficiary-triggered event (divorce, dependent aging out, disability)
Deadline: Beneficiary has 60 days to notify; administrator then has 14 days
Notes: Clock runs from the administrator's receipt of notice, not the event.
  • Employee identifiers: Full name, last known mailing address, and SSN or unique plan ID.
  • Beneficiary list: Names and addresses of each qualified beneficiary (spouse, dependents); each may need a separate notice.
  • Event details: Qualifying event date and event type (termination, reduction in hours, divorce, death, and so on).
  • Plan and premium details: Coverage options available for continuation, current premium amounts, and how long continuation coverage will last.
  • The model notice: The DOL model election notice; see the Model Notice section below.
1
Confirm the qualifying eventIdentify the event type, date, and which individuals lose coverage as a result.
2
Identify all qualified beneficiariesInclude the employee, spouse, and each covered dependent; each is entitled to their own notice and their own election rights.
3
Determine who administers COBRAEmployer, TPA, or insurer: this determines your deadline and who sends the notice.
4
Prepare the election noticeUse the DOL model notice (see below) and fill in plan details, coverage options, premium amounts, and deadlines.
5
Send and logMail via first-class mail to each beneficiary's last known address; record the date, method, and recipient for each notice sent.
6
Track the election windowBeneficiaries have 60 days from the later of the notice date or the date coverage is lost to elect COBRA.
  • Who receives it: Each qualified beneficiary at their last known mailing address, not just the employee. Spouses and dependents at different addresses need their own mailings.
  • Method: First-class mail to the last known address is the legal standard and creates a presumption of receipt under ERISA; the burden then shifts to the beneficiary to prove they didn't receive it.
  • Proof of mailing: A Certificate of Mailing (USPS Form 3817), available at the post office, is an inexpensive way to get a dated, stamped record proving when you deposited the notice. This is the recommended approach for documentation without the complications of certified mail.
  • Avoid certified mail for routine notices: If the recipient doesn't retrieve a certified letter, it comes back to you as undeliverable, which can undermine the presumption of receipt that first-class mail provides.
  • Electronic delivery: Permitted only if the DOL's ERISA electronic disclosure safe harbor rules are met (employee consent, confirmed access, and so on).
  • Copy of each notice sentThe exact notice (including all plan-specific fields filled in) for each qualifying event.
  • Mailing logDate, method, and recipient name and address for each beneficiary, maintained separately for each qualifying event.
  • Event and election logQualifying events, notification dates, and election responses.
  • Retention periodKeep records for at least 6 years per ERISA's general recordkeeping requirement.

Common traps

Sending to the employee only: Each qualified beneficiary is entitled to their own notice and their own election rights.
Starting the deadline from the wrong date: The clock runs from when the plan administrator is notified, not from the qualifying event date, and the two can differ.
Forgetting beneficiary-triggered events: Divorce, disability, or a dependent aging out may never reach HR, so you need a system to catch them.
Omitting current premium amounts: The notice must include the actual cost of continuation coverage.

FAQs

What is a COBRA Election Notice?
A written notice sent to qualified beneficiaries after a qualifying event, explaining their right to elect continuation of group health coverage and how to do so.

Who must receive it?
Every qualified beneficiary, not just the employee. This includes covered spouses and covered dependent children, each of whom has independent election rights.

How long do beneficiaries have to elect COBRA?
60 days from the later of the date the election notice is sent or the date coverage is lost.

What are the penalties for a late or missing notice?
IRS excise tax of $100 per day per qualified beneficiary under IRC §4980B (or $200/day for multiple family members from the same qualifying event), plus up to $110 per day per beneficiary in court-assessed ERISA §502(c)(1) penalties. Employers may also face ERISA lawsuits and, in some cases, liability for the beneficiary's uncovered medical costs during the coverage gap.

Which employers are subject to COBRA?
Employers with 20 or more employees. See the COBRA General Notice page for how to count employees and which plans are exempt.

  • Mini-COBRA: Below the federal 20-employee threshold, your state's continuation-coverage law may apply instead. See the State Continuation Election Notice page.
  • Disability extension: If a qualified beneficiary is determined disabled by the SSA at the time of a qualifying event, the maximum coverage period extends from 18 to 29 months. The beneficiary must notify the plan of the disability within 60 days of the SSA determination.
  • Second qualifying event: If a second qualifying event occurs during an 18-month continuation period (for example, the employee dies or divorces), coverage for the affected beneficiary may extend to 36 months.
  • Multiple EINs / controlled groups: Clearly identify the plan sponsor and plan administrator in the notice, especially in related-entity situations.
DOL MODEL COBRA ELECTION NOTICE

The DOL provides an official model election notice in Word format. Download it, complete the plan-specific fields, and it satisfies the federal notice requirement.

Download the DOL Model COBRA Election Notice (Word)

The model covers all federally required content. For each qualifying event, complete these fields before sending:

  • Plan name and coverage type: the official name of the group health plan or plans available for continuation.
  • Plan administrator name and contact information: name, address, and phone number.
  • Qualified beneficiaries: names of all individuals entitled to elect COBRA under this event.
  • Qualifying event date and type: for example, termination of employment on [date].
  • Election deadline: 60 days from the later of the notice date or the date coverage ends.
  • Premium amounts: the actual monthly cost for each coverage option available (including the 2% administrative fee if applicable).
  • Payment instructions: where to send premiums and by when.

Send a completed copy to each qualified beneficiary at their last known mailing address and retain a copy with your mailing log.