This notice contains important information regarding your COBRA coverage. Please read the notice carefully. Your COBRA coverage has been terminated for you and all applicable covered family members.
If you incurred any eligible expenses for which you are due reimbursement for the plan(s) listed above, you should file your claim with your insurance carrier(s) in the usual manner within the next 90 days.
Please note, we have used the information supplied by previous employer to calculate your maximum continuation period under the plan(s) you were insured prior to your qualifying event. If there is a discrepancy between our calculation and the underwriting insurance carrier, the insurance carrier always governs. Please contact your insurance carrier(s) to determine the exact end of your maximum continuation period.
Finally, if you are receiving this letter due to the expiration of your maximum continuation period, and if the last day of your continuation period occurred on a date in the middle of a calendar month, this letter may have been sent prior to receipt of your payment for your final partial month of coverage. If you have not yet paid for your final partial month of coverage and still intend to do so, you have until the normal expiration of the payment grace period for this final month to postmark your payment.
If you believe this termination date is incorrect, you may file an appeal. The appeal must be submitted within 30 days of you receipt of this termination notice and include a detailed account of your case, including the reasons you believe your coverage was improperly terminated, and include all information you wish to be reviewed. Please also include your name and contact information.
Your appeal must be submitted in writing to:
90 Woodbridge Center Drive
Suite 405
Woodbridge NJ 07095 US
If we do not receive an appeal notice by the 30-day deadline, your coverage will remain terminated without any opportunity to reinstate.
If you have any questions regarding your coverage, please contact us at 888-423-6359 or chat with us anytime.
