COBRA Qualifying Event
Press Submit below to send the data to The Conestoga Group. You will receive a confirmation email within 48 business hours of receipt of your submission. If you do not receive a confirmation email, please contact firstname.lastname@example.org.
1 The date of the qualifying event is the last day of employment under a termination, effective date of a divorce, reduction of hours, loss of dependent status or date of death of an employee.