{
 "asOf": "2026-10-05",
 "noticeType": "general",
 "noticeDate": "2026-10-05",
 "coverageStartDate": "2026-09-01",
 "noticeText": "GENERAL NOTICE OF COBRA CONTINUATION COVERAGE RIGHTS\n\nExample Manufacturing Group Health Plan\n\nYou are getting this notice because you recently gained coverage under the Example Manufacturing Group Health Plan (the Plan). This notice has important information about your right to COBRA continuation coverage, a temporary extension of coverage under the Plan. This notice does not fully describe continuation coverage or other rights under the Plan. More complete information is available in the Plan's summary plan description or from the Plan Administrator.\n\nWhat is COBRA continuation coverage?\nCOBRA continuation coverage is a continuation of Plan coverage when it would otherwise end because of a life event, called a qualifying event. You, your spouse and your dependent children could become qualified beneficiaries if coverage under the Plan is lost because of a qualifying event. Qualified beneficiaries who elect COBRA must pay for it: the premium is up to 102 percent of the cost of coverage.\n\nIf you are an employee, you will become a qualified beneficiary if you lose coverage because your hours of employment are reduced (a reduction in hours) or your employment ends for any reason other than gross misconduct (termination). Your spouse becomes a qualified beneficiary if coverage is lost because of your death, a reduction in your hours, the end of your employment, your becoming entitled to Medicare, or a divorce or legal separation. Your dependent children become qualified beneficiaries for the same reasons, or if they stop being eligible as a dependent child.\n\nWhen is COBRA continuation coverage available?\nWhen the qualifying event is the end of employment, a reduction in hours, the death of the employee, or the employee becoming entitled to Medicare, the employer must notify the Plan Administrator of the qualifying event.\n\nYou must give notice of some qualifying events\nFor a divorce, a legal separation, or a child losing dependent status, you must notify the Plan Administrator within 60 days after the qualifying event occurs. Send the notice in writing to the Plan Administrator at the address below, on the form the Plan provides.\n\nHow long does COBRA last?\nCOBRA continuation coverage generally lasts up to 18 months for the end of employment or a reduction in hours, and up to 36 months for the other qualifying events. If the Social Security Administration determines that a qualified beneficiary is disabled, coverage may be extended by up to 11 months; you must notify the Plan Administrator of the disability determination within 60 days. A second qualifying event during the first 18 months can extend coverage for a spouse and dependent children up to 36 months in total.\n\nKeep your Plan informed of address changes\nTo protect your family's rights, let the Plan Administrator know about any changes in the addresses of family members.\n\nPlan contact information\nExample Benefits Administration, Plan Administrator, 100 Example Way, Suite 200, Anytown, ST 00000. Telephone: (555) 010-0100.\n"
}