As a DEBCP (Designated Employee Benefits Contact Person) you must provide the Request for Continuation of Coverage - COBRA form to employees as appropriate.
Since this is a carbon copy (duplicate) form, it is not available on the internet, and must be completed either by typewriter or pen -with signature(s) required.
You should request forms directly from Employee Benefits by phone at (612) 624-9090 or via email at: benefits@umn.edu
Further information and other related forms are available on the Employee Benefit website at: http://www1.umn.edu/ohr/debcp/index.html
Since this is a carbon copy (duplicate) form, it is not available on the internet, and must be completed either by typewriter or pen -with signature(s) required.
You should request forms directly from Employee Benefits by phone at (612) 624-9090 or via email at: benefits@umn.edu
Further information and other related forms are available on the Employee Benefit website at: http://www1.umn.edu/ohr/debcp/index.html
