# Benefit Resource COBRA Form: Fill Out, Sign and Send It

> Benefit Resource says the administrator sends paperwork and an election form with the COBRA Specific Rights Notice. If yours arrived as a PDF, fill it in, sign it and download it here, then return it as your notice says.

Page: https://pdfinish.com/cobra-forms/benefit-resource
Last updated: October 27, 2026

## What Benefit Resource says

- Benefit Resource's New to COBRA page says that after a qualifying event the employer gives the third-party administrator the required information, so the administrator can send the member paperwork and an election form, the Specific Rights Notice. ([source](https://www.benefitresource.com/resources/new-to-cobra/))
- It says the Specific Rights Notice is also called a COBRA qualifying event letter or election notice. ([source](https://www.benefitresource.com/resources/new-to-cobra/))
- It says that notice reviews how to elect COBRA coverage, pay premiums and end coverage. ([source](https://www.benefitresource.com/resources/new-to-cobra/))
- It says a takeover notice, sent when it takes over administration, helps members get online so they can pay premiums and make an initial election if one is pending. ([source](https://www.benefitresource.com/resources/new-to-cobra/))
- The page says people can elect each benefit separately, and gives the example of electing COBRA only for dental coverage while using the Federal Exchange for health coverage. ([source](https://www.benefitresource.com/resources/new-to-cobra/))
- The site menu lists a COBRA and Direct Bill portal for participants. ([source](https://www.benefitresource.com/resources/new-to-cobra/))

## If your paperwork is a PDF

The page we read does not say how to return the election form, and it does not say the form comes as a PDF. Which options your plan offers is in your notice.

These steps are for the election form from a Benefit Resource Specific Rights Notice, once it is in your hands as a PDF.

## Steps

1. **Open the notice package.** Find the election form that came with the Specific Rights Notice, then drop it onto Fill and Sign PDF.
2. **Fill in the election.** Type your details and mark the choices on the lines the form gives you. Take your time with any box that applies to a single benefit.
3. **Sign and date.** Add your signature and the date, then check that no required line is blank.
4. **Download and return it.** Save the signed PDF and send it as the notice instructs. Benefit Resource's page leaves the method to the notice, so do the same.

## What to keep

- The Specific Rights Notice itself, which explains how to elect and pay.
- The signed election form as a PDF.
- A record of the day and method you used to return it.

## Common questions

### What is the Specific Rights Notice at Benefit Resource?

Its page calls it the notice a qualified beneficiary gets after a qualifying event, also known as a COBRA qualifying event letter or election notice. It explains how to elect, pay and end coverage.

### Who sends the Benefit Resource election form?

The page says the employer informs the third-party administrator, which then sends the member paperwork and an election form.

### Does Benefit Resource have a COBRA portal?

Its site menu lists a COBRA and Direct Bill portal, and a takeover notice is described as helping members get online to pay and make a pending initial election.

### Can I elect only some benefits at Benefit Resource?

Its training page says each benefit can be elected separately, with dental as its example. Your own notice lists the choices your plan offers.

## Sources

- [Benefit Resource, New to COBRA](https://www.benefitresource.com/resources/new-to-cobra/)

PDFinish is not affiliated with Benefit Resource. We describe what Benefit Resource says on its own public pages, and we do not host or change its forms. General information, not legal, tax or insurance advice.