• The Initial COBRA Notice (to be renamed the General Notice)
  
• The COBRA Election Notice
  
• The Summary Plan Description
  
• The Summary of Material Modification
  
• The Certificate of Creditable Coverage
  
• The Medical Child Support Order
  
• The National Medical Support Notice
  

• Initial COBRA Notice
  Type of information: This document is a notice of the right to purchase temporary group health coverage when plan coverage is lost due to a qualifying event, such as termination or reduction in hours.
  
  To whom: All covered employees and covered spouses.
  
  When must the initial COBRA notice be provided: At the time group health plan coverage commences.

• COBRA Election Notice
  Type of information: This document is a notice to "qualified beneficiaries" of their right to elect COBRA coverage upon the occurrence of a COBRA qualifying event.
  
  To whom: All covered employees, covered spouses and their dependent children who are COBRA qualified beneficiaries.
  
  When must the COBRA election notice be provided: The plan administrator must provide qualified beneficiaries with the election notice within 14 days after being notified by the employer or qualified beneficiary of the COBRA qualifying event.

• Summary Plan Description (SPD)
  Type of information: The SPD is the primary vehicle for informing plan participants and beneficiaries about their plan and how it operates. This document must be clearly written in language that the "average participant" can understand and be comprehensive enough to inform all covered persons of their benefits, rights and obligations under the plan. (Note: SPDs must now specifically reflect a description of COBRA rights.) A very important ERISA requirement is that the information contained in SPDs must be current. If a plan is changed, participants must be informed, either through a revised SPD, or in a separate document called a summary of material modifications (see below). The SPD must accurately reflect the plan's contents as of 120 days prior to the date on which it is provided. In other words, a plan description that is more than 4 months old, and does not reflect more recent changes to the plan, does not conform to ERISA regulations. ERISA rules govern style, format and content requirements of SPDs.
  
  To whom: The SPD must be provided to all participants in the group plan and to all beneficiaries who receive benefits from the plan, including COBRA beneficiaries. ERISA states that foreign language assistance may need to be provided when a portion of the plan participants is literate only in the same non-English language.
  
  When must the SPD be provided: A current copy of the SPD must be provided automatically to plan participants within 90 days of when they become covered by the plan. (But a plan has 120 days after first becoming subject to ERISA rules to distribute the SPD.) An updated SPD must be provided every 5 years if changes have been made to the contents, or when a plan is amended. (See below for providing notice of changes sooner by a Summary of Material Modification.) If no changes or amendments are made to a plan, new copies of SPDs must still be furnished to participants every 10 years. And if a participant or beneficiary makes a written request for a copy of the SPD at any time, it must be furnished no later than 30 days after the request is made.

For more on SPD COBRA-related requirements, go to: Summary Plan Descriptions

• Summary of Material Modification (SMM)
  Type of information: The Summary of Material Modification contains changes and modifications made to the information that must be included in a plan's SPD. It is the document by which participants are notified of important amendments to their plan, including changes made to their COBRA rights. It is used to impart information that is required to be contained in the SPD, and substitutes for providing a revised version of the entire SPD. However, if an updated SPD is provided, it satisfies the requirement of providing an SMM.
  
  To whom: The SMM must be given to the same persons who have the right to receive copies of the SPD, including those who request updated information at any time.
  
  When must the SMM be provided: Participants and beneficiaries, including COBRA recipients, must receive copies of an SMM automatically whenever it is updated to reflect material modifications to a plan, but not later than 210 days after the end of the plan year in which a change or amendment to the plan is made.
  

• Certificate of Creditable Coverage
  Type of information: This notice documents an employee's prior group health plan coverage.
  
  To whom: All group plan participants and beneficiaries who lose health coverage must receive a Certificate of Creditable Coverage.
  
  When must the Certificate of Creditable Coverage be provided: This document must be provided automatically when a participant or beneficiary loses group health plan coverage, becomes eligible for COBRA coverage, and when COBRA coverage ends. A Certificate of Creditable Coverage must be provided free of charge anytime prior to the loss of health plan coverage, or upon request within 24 months of losing coverage.
  

• Medical Child Support Order (MCSO)
  Type of information: The MCSO is an order that requires the plan to provide health insurance, including COBRA continuation coverage to a participant's noncustodial child.
  
  To whom: The plan administrator must send the MCSO to affected health plan participants, to any child named in the order, and to that child's parent or legal representative.
  
  When must the Medical Child Support Order be provided: As soon as the plan administrator receives an MCSO, usually as a result of a divorce proceeding, it must issue notice of the order and the plan's procedures for determining the order's qualified status.
  

• National Medical Support Notice (NMSN)
  Type of information: NMSNs are used by state welfare agencies that are responsible for enforcing health care coverage provisions, including COBRA continuation coverage, contained in medical support orders. Depending on the circumstances of each situation, an employer may be required to complete Part A of the NMSN and return it to the state agency, or transfer Part B to the plan administrator for a determination on whether the notice qualifies as an MCSO.
  
  To whom: The NMSN must be forwarded to employers, plan administrators, participants, custodial parents, children and their legal representatives. Part A, if required, must be sent to the state agency that forwarded the notice to the employer.
  
  When must the National Medical Support Notice be provided: The employer must send either Part A to the proper state agency, or Part B to the plan administrator no later than 20 days after the date of the notice. The plan administrator has 40 business days in which to complete and return Part B to the state agency and provide required information to all affected persons.

For more information about NMSNs, go to: National Medical Support Notices