Adams® COBRA Late Payment Notice, 1-Use Interactive Digital Legal Form

1 form

Employers or plan administrators may use this letter as a notice of late payment to an employee or beneficiary receiving group health plan coverage under the Consolidated Omnibus Budget Reconciliation Act (COBRA).

Available in increments of 1
  • Letter provides notice of late payment for those electing continuation of coverage under COBRA
  • Provides date by which coverage will be terminated without further payment
  • Offers contact information for persons needing further assistance
  • Attorney-reviewed form valid for general use in every state
  • Click the secure link in your account to begin the interactive Q&A that creates your legal form
  • Responses auto save as you work; return any time to complete your secure form at
  • Online Guidance Notes offer additional information on signing, filing, and executing your documents
  • Download to save and print your customized PDF file
More Information
Item # DLF499-SL
Purchasing Quantity 1 form
Write Your Own Review