Transaction Desired
Term employee - no COBRA desired or hasn't decided on COBRA yet
Term employee - COBRA desired
Term dependent - no COBRA desired or hasn't decided on COBRA yet
Term dependent - COBRA desired
Term employee - no COBRA desired for employee but wants COBRA for dependents
Term employee - place employee and dependents on COBRA

COBRA Type
Self Administers COBRA or COBRA Administered by other than BCBST
Purchased COBRA Administration from BCBST

Form Type
Scannable Paper Form
eHealth Services