tion of group coverage. 5. Continued group coverage must end no later than: Signature of Plan Administrator and Date Please Return This Form To: CareFirst 840 First Street, NE Washington, DC 20065 Attention: Account Implementation Department Mailstop 31 CareFirst BlueCross BlueShield is the busines

ark Tollison To:' <Ma> Subject: Please print 2 of the attachment for Mark Date: Fri, 20 Sep 2013 19:19:05 +0000 Importance: Normal Attachments: CareFirst COBRA Form.pdf Best regards, Mark Tollison The information contained in this e-mail is confidential and is intended solely for the use of the addr