Meritain Health, Inc. fax number

Fax destination details

Department

COBRA Administrator

Purpose

Submitting COBRA continuation coverage notices (e.g., notices of qualifying events, disability, and related elections) to the COBRA Administrator for Meritain Health, Inc., the plan's COBRA administrator.

Form

COBRA Notice — COBRA Continuation Coverage Notice

Address

Meritain Health, Inc. COBRA Administrator, P.O. Box 27158, Lansing, MI 48909-7158

Voice phone

(866) 808-2609

Website

Visit organization website

Before you send

• Confirm that this exact department handles your document or request.
• Check the organization website or call its main line for the current fax number.
• Include a cover sheet and any case, member, claim, or form reference required.
• Keep the delivery confirmation with your submission records.

Notices must be postmarked or received by the COBRA Administrator. The notice should include: (1) name and address of the covered Employee; (2) name and address of the Spouse, former Spouse and any Dependents; (3) description of the qualifying event; and (4) the date of the qualifying event. If a disability extension applies, include SSA disability determination information. The COBRA Administrator for this plan is Meritain Health, Inc.