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COBRA Notification Checklist

HR and Benefits Administration Resource

Administer continuation coverage with a COBRA notification checklist for HR, benefits administrators, and employers. Collect the qualifying-event record, covered-individual details, plan documents, election and notice copies, and payment records so federal COBRA (and any state mini-COBRA) files are complete. Deadlines and form of notice are statute-driven and can change. This is not legal advice; confirm current federal and state rules and your plan’s SPD before sending notices.

COBRA Notification Checklist form template preview

Key Benefits

File the qualifying event and coverage end date
Identify all qualified beneficiaries to notify
Keep election notice and SPD copies together
Track election, waiver, and payment records
Separate federal COBRA from state mini-COBRA
Support audits with a complete notice packet

Common Use Cases

HR processing a termination qualifying eventBenefits teams handling divorce or dependent lossReduction in hours that ends group coverageEmployers using a COBRA administrator (TPA)State mini-COBRA for smaller group plansPreparing a benefits file for audit or litigation hold

Frequently Asked Questions

What is a COBRA qualifying event?
Common events include termination of employment, reduction in hours, death of the employee, divorce or legal separation, and a dependent aging out. The event and who is a qualified beneficiary determine who must receive notices. Confirm the current statutory list and your plan terms.
Does every employer have to offer federal COBRA?
Federal COBRA generally applies to group health plans of employers with 20 or more employees. Smaller employers may still have state mini-COBRA or other continuation rules. Confirm coverage-size tests and state law; this checklist is not a determination of applicability.
What notices are typically in the file?
Files often include the general COBRA notice (often at hire), the election notice after a qualifying event, any notices from the administrator, the completed election or waiver, and payment correspondence. Content and timing are regulated—use current model language or counsel-approved forms.
Is this legal advice?
No. COBRA and mini-COBRA deadlines, notice content, and premium rules are technical and fact-specific. Use this as a document checklist and confirm current rules with counsel or your TPA before sending notices or denying coverage.

Checklist

Event

Qualifying-event type, event date, and coverage end date
Required

Termination, hours reduction, divorce, death, or dependent loss—as applicable.

People

Names and addresses of all qualified beneficiaries
Required

Employee, spouse, and dependent children who lose coverage.

Plan

Plan name, SPD, and coverage types that may continue
Required

Medical, dental, vision, and any other continuation-eligible coverages.

Notices

Copy of the general COBRA notice provided at coverage start

Often delivered at hire or when coverage begins.

Election notice copy, send date, and delivery method
Required

Keep proof of mailing or electronic delivery per your procedure.

Election

Signed election, waiver, or expiration of the election period
Required

Who elected, for whom, and which coverages.

Payments

Premium amount, first-payment deadline, and payment records
Required

Administrator invoices and NSF or late-payment correspondence.

State

State mini-COBRA or other continuation notices if applicable

Small-employer or extra-month rules vary by state.