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Dos and Don'ts

When filling out the Maryland Continuation Election form, it’s essential to approach the process with care. Here are seven important dos and don’ts to keep in mind:

  • Do read the MD Continuation Coverage Notice thoroughly before completing the form.
  • Do ensure that you select the correct type of insurance and coverage that suits your needs.
  • Do attach any required documentation, such as a new application if applicable.
  • Do provide accurate information, including your Social Security number and billing address.
  • Don’t forget to sign and date the form; an unsigned form may be rejected.
  • Don’t leave any sections blank; incomplete forms can delay your coverage.
  • Don’t submit the form without including your first payment, as coverage will not begin until payment is received.

Misconceptions

Understanding the Maryland Continuation Election form is essential for making informed decisions about your health coverage. Here are some common misconceptions surrounding this form:

  • Misconception 1: The form guarantees immediate coverage.

    • Many people believe that simply submitting the form ensures they will receive immediate health coverage. In reality, coverage begins only after the first payment is received.

  • Misconception 2: You can add dependents at any time.

    • Some individuals think they can add dependents whenever they choose. However, dependents can only be added during Open Enrollment or if there is a change in family status.

  • Misconception 3: The election form is optional.

    • It is a common belief that completing the election form is optional. In fact, if you wish to continue your coverage, submitting the form is a necessary step.

  • Misconception 4: All types of insurance can be selected at any time.

    • Some people assume they can choose any type of insurance whenever they want. However, you may only select the types of insurance available at the time of your election.

  • Misconception 5: The effective date of coverage is the same as the date the form is submitted.

    • It is often misunderstood that the effective date of coverage is when the form is turned in. Instead, the effective date is based on the specifics outlined in the plan and may differ.

  • Misconception 6: You do not need to read the accompanying documents.

    • Many people overlook the importance of reading the MD Continuation Coverage Notice and the accompanying letter. These documents provide crucial information about your rights and limitations regarding coverage.

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Key takeaways

When filling out and using the Maryland Continuation Election form, consider the following key takeaways:

  • Understand the Coverage: Make sure you are familiar with the Employee Benefit Plan and what it entails.
  • Read the Notices: It is important to read the MD Continuation Coverage Notice and the accompanying letter thoroughly.
  • Qualifying Events: Identify the reason for your election, such as termination of employment, death, or divorce.
  • Payment Requirement: Include your first payment with the form. Without it, you will not have access to healthcare coverage.
  • Type of Insurance: Select the type of insurance you wish to continue, which may include health, dental, or vision.
  • Coverage Selection: Choose the appropriate coverage level, such as individual, husband/wife, parent/child, or family.
  • Witness Signature: Ensure that a witness signs the form, as this may be required for processing.

These points can help ensure a smoother process when applying for continuation coverage in Maryland.

Guidelines on Utilizing Maryland Continuation Election

Completing the Maryland Continuation Election form is an important step for individuals seeking to maintain their health insurance coverage after a qualifying event. Once the form is filled out, it should be submitted to the appropriate party, ensuring that all necessary information is accurate and complete. Below are the steps to guide you through the process of filling out this form.

  1. Begin by entering the Name of Company that provides the Employee Benefit Plan under which you wish to continue coverage.
  2. Indicate whether you wish to continue coverage by selecting YES or NO.
  3. If you selected YES, attach a new application as required.
  4. Fill in the effective date of continuation coverage.
  5. State whether the first payment is enclosed by selecting YES or NO. Remember, if the first payment is not enclosed, access to health care coverage will be delayed until payment is received.
  6. Identify the qualifying event that prompted this election by checking one of the following options: Termination of Employment, Death, or Divorce.
  7. Select the type of insurance you wish to continue: Health, Dental, or Vision. Note that you may not add lines of insurance until Open Enrollment.
  8. Choose the type of coverage you desire: Individual, Husband/Wife, Parent/Child, or Family. Keep in mind that dependents may not be added until Open Enrollment unless there is a change in family status.
  9. Sign and date the form where indicated.
  10. Print your name and provide your Social Security Number.
  11. Have a witness sign the form in the designated area.
  12. For employer use, complete the section for continuation coverage end date, and indicate whether the billing will be directed to the company or to the qualified beneficiary.
  13. Finally, fill in the billing address, including the city, state, and zip code.

Form Preview Example

MARYLAND CONTINUATION ELECTION FORM

I wish to continue coverage under the <Name of Company> Employee Benefit Plan. I understand that this election is subject to the Plan. I have read and understand the MD Continuation Coverage Notice and the letter that accompanied this election form and both MD Continuation rights and limitations on those rights.

YES NO

IF YES, PLEASE ATTACH A NEW APPLICATION

Effective date of continuation coverage:

 

First payment is enclosed:

YES

NO

 

(If first payment is not enclosed, you will not be able to access health care coverage until payment is received.)

Qualifying Event:

Termination of Employment

Death

Divorce

Type of Insurance Selected:

Health

Dental Vision

(May not add lines of Insurance until Open Enrollment.)

Type of Coverage Selected:

Individual Husband/Wife Parent/Child

Family

 

 

 

 

 

 

(Dependents may not be added until Open Enrollment unless a

 

 

 

 

 

 

change in family status occurs.)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Signature

Date

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Print Name

Social Security Number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Signature of Witness

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

For Employer to complete:

Continuation coverage end date:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Bill to Company:

 

 

 

 

Bill to Qualified Beneficiary:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Billing address

 

 

 

 

 

 

 

 

City

State

Zip

Common mistakes

  1. Not Reading the Instructions Carefully: Many individuals rush through the form without fully understanding the instructions. This can lead to missed sections or incorrect selections. Taking the time to read each part can prevent errors that might delay coverage.

  2. Failing to Attach Required Documentation: If you select "YES" to continue coverage, you must attach a new application. Forgetting this crucial step can result in your request being denied, leaving you without coverage when you need it most.

  3. Incorrectly Indicating the Qualifying Event: It's essential to accurately select the qualifying event that applies to your situation, whether it’s termination of employment, death, or divorce. An incorrect choice can lead to complications in your coverage status.

  4. Not Submitting the First Payment: If the first payment is not included with your form, you will be unable to access health care coverage. This can create a gap in your insurance that could have serious consequences for your health and finances.

Free Maryland Continuation Election PDF

Learn More on This Form

What is the Maryland Continuation Election Form?

The Maryland Continuation Election Form is a document that allows individuals to continue their health insurance coverage after certain qualifying events, such as job termination, divorce, or death of a covered family member. By filling out this form, individuals can maintain their benefits under their employer's Employee Benefit Plan for a limited time, as specified by Maryland law.

What are the qualifying events for using this form?

Qualifying events include termination of employment, death of a covered employee, or divorce. Each of these events can trigger the right to continue health coverage under the Maryland Continuation law. It is important to note that the continuation of coverage is subject to specific rules and limitations outlined in the MD Continuation Coverage Notice.

How do I complete the form?

To complete the form, you will need to provide your personal information, including your name and Social Security number. Indicate whether you wish to continue coverage and attach a new application if necessary. You must also select the type of insurance you want (health, dental, or vision) and the type of coverage (individual, family, etc.). Finally, sign and date the form, and ensure that a witness also signs it.

What happens if I do not include my first payment?

If you do not enclose your first payment with the form, you will not be able to access health care coverage until that payment is received. It is crucial to make sure that your payment is included to avoid any gaps in your coverage.

Can I add dependents to my coverage?

Generally, you cannot add dependents to your coverage until the next Open Enrollment period. However, if there is a change in family status, such as marriage or birth of a child, you may be able to add them outside of the Open Enrollment period. Be sure to check the specific rules of your employer's plan for more details.

What is the effective date of continuation coverage?

The effective date of continuation coverage is typically the date following the qualifying event. This date may vary based on the specific circumstances of your situation and the policies of your employer's plan. It is advisable to review the MD Continuation Coverage Notice for more information on effective dates.

What should I do if I have questions about the form?

If you have questions about the Maryland Continuation Election Form or the continuation of your coverage, it is best to reach out to your employer's human resources department or the benefits administrator. They can provide clarification and guidance tailored to your specific situation.

What is the billing process for continuation coverage?

The billing process will depend on how your employer has set up the continuation coverage. You may be billed directly, or your employer may handle the billing. The form allows you to specify whether the bill should be sent to the company or to you as the qualified beneficiary. Ensure that the billing address is accurate to avoid any issues with payment.