- COBRA Refund Request Form
- Please use this form to authorize an ACH refund to your account.
- PHI Authorization/Revocation Form
- COBRA Brochure
- Answers the many questions you may have regarding your COBRA benefits.
245 Kenneth Drive
Rochester NY 14623-4277
Benefit Resource, LLC
PO BOX 642
Willow Grove, PA 19090
EMPLOYEES: (800) 473-9595
EMPLOYERS: (866) 996-5200
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