2014 COBRA Continuation or Extension of Coverage • Type or print clearly in black ink. Inaccurate, incomplete, or illegible information may delay coverage. • You must submit this form no later than 60 days after th - 60 Days In - Document - PDFSEARCH.IO

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	2014 COBRA Continuation or Extension of Coverage • Type or print clearly in black ink. Inaccurate, incomplete, or illegible information may delay coverage. • You must submit this form no later than 60 days after th Add to Reading List Document Date: 2014-06-17 17:44:30 Open Document File Size: 275,33 KB Share Result on Facebook City Washington / Olympia / Seattle / Hillsboro / / Company Group Health Value Group Health Options Inc. / Washington Inc. / HCA / Willamette Dental Group / Group Health Options Inc. / / Country United States / / Currency USD / / Facility Campus Way / / IndustryTerm tobacco product / through health insurance / insurance coverage / insurance / limited provider network / life insurance / federal tax law / / Organization Washington State Health Care Authority / Preferred Provider Organization / State’s Office / Medicare / / / Position Governor / Dentist / Washington Secretary / / ProvinceOrState Oregon / Washington / / URL www.hca.wa.gov / www.hca.wa.gov/pebb / / SocialTag Government Federal assistance in the United States Healthcare reform in the United States Presidency of Lyndon B. Johnson United States Medicare Medicaid Consolidated Omnibus Budget Reconciliation Act Medigap Health

2014 COBRA Continuation or Extension of Coverage • Type or print clearly in black ink. Inaccurate, incomplete, or illegible information may delay coverage. • You must submit this form no later than 60 days after thAdd to Reading List