Froggy Jumps for Forms

Froggy Jumps

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About this activity

Play this game to test your knowledge on the top 6 forms we use.

Created by

Teri Training

United States

Download the paper version to play

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Froggy Jumps Froggy Jumps for FormsOnline version Play this game to test your knowledge on the top 6 forms we use. by Teri Training 1 This form is used by internal reps to complete so that the QB can get another 11 months of COBRA. a Disability Extension Reporting Form b Secondary Event Reporting Form c Carrier Acknowledgement Form 2 True or False: this form is completed for QB's who have experienced a Second COBRA Event and get an extenson. a False b True c I don't know. 3 This Form is completed when..... a Client wants us to cancel their services. b Client wants us to extend their QB's coverage. c Client wants us to send the COBRA premiums to the carrier(s) directly. 4 When clients want the COBRA premiums to be sent to them via direct deposit, they need the... a Banking Authorization Form b Banking Institution Form c Banking Account Form 5 This form is completed by the client and returned whenever the client wants to... a Have their carrier receive the Daily Status Change Report b Have their carrier receive the Client Participant Status Report c Have their carrier receive the Notices Mailed Report 6 Clients can add their new Broker of Record and _______ their Secondary contacts with this form a and/or remove b cancel their services c add a QB

Froggy Jumps

Froggy Jumps for FormsOnline version

Play this game to test your knowledge on the top 6 forms we use.

by Teri Training

This form is used by internal reps to complete so that the QB can get another 11 months of COBRA.

Disability Extension Reporting Form

Secondary Event Reporting Form

Carrier Acknowledgement Form

True or False: this form is completed for QB's who have experienced a Second COBRA Event and get an extenson.

False

True

I don't know.

This Form is completed when.....

Client wants us to cancel their services.

Client wants us to extend their QB's coverage.

Client wants us to send the COBRA premiums to the carrier(s) directly.

When clients want the COBRA premiums to be sent to them via direct deposit, they need the...

Banking Authorization Form

Banking Institution Form

Banking Account Form

This form is completed by the client and returned whenever the client wants to...

Have their carrier receive the Daily Status Change Report

Have their carrier receive the Client Participant Status Report

Have their carrier receive the Notices Mailed Report

Clients can add their new Broker of Record and _______ their Secondary contacts with this form

and/or remove

cancel their services

add a QB

You can integrate the game into an LMS compatible with LTI 1.1 or LTI 1.3 such as Canvas, Moodle, or Blackboard. This way, the scores will be automatically saved into the platform’s gradebook.

Froggy Jumps for Forms

Froggy Jumps

About this activity

Created by

Download the paper version to play

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Froggy Jumps for FormsOnline version

by Teri Training

This form is used by internal reps to complete so that the QB can get another 11 months of COBRA.

True or False: this form is completed for QB's who have experienced a Second COBRA Event and get an extenson.

This Form is completed when.....

When clients want the COBRA premiums to be sent to them via direct deposit, they need the...

This form is completed by the client and returned whenever the client wants to...

Clients can add their new Broker of Record and _______ their Secondary contacts with this form

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