Earlier this month, President Biden signed the law ending the Covid-19 national emergency (NE) immediately vs. the May 11, 2023 end date, and created a whirlwind of confusion about changes to employee health plans.
Which Orders, Which Dates?
The early days of the COVID-19 pandemic were marked by several emergency declarations that allowed the government to take sweeping steps to respond to the virus and support the country’s economic, health and welfare systems. Some emergency measures have already been successfully wound down, while others are still being phased out.
Two primary legislative COVID-19 orders affected worker health plans, and below is the clarification of deadline requirements.
1. The Public Health Emergency (PHE), in effect since January 2020, impacted the requirements to cover COVID-19 testing and vaccine services. PHE will continue through May 11, 2023, as planned. The Departments of Labor, Treasury and Health and Human Services issued new guidance about the PHE as follows:
- COVID-19 Testing
Healthcare plans will no longer be required to provide free COVID-19 diagnostic testing, including over-the-counter tests, after May 11, 2023. The Departments encourage plans to continue covering these tests, however. Plans that opt to eliminate COVID-19 testing coverage after May 11, 2023, should communicate those changes to employees beforehand, including an explanation of any cost-sharing, prior authorization or other requirements.
- COVID-19 Vaccines
Non-grandfathered health plans must continue to provide employees with COVID-19 vaccines, boosters and other preventative services from in-network providers without cost sharing as part of the Affordable Care Act preventive services mandate. If a health plan does not have an in-network provider for immunizations, the plan must cover the item or service when furnished by an out-of-network provider and may not impose cost sharing.
2. The National Emergency (NE), in effect since March 2020, was tied to extending specific Cobra and HIPPA deadlines that would have otherwise expired during the Outbreak Period. Outbreak Period is defined as beginning March 1, 2020, and ending 60 days after the end of the NE. Fortunately, the Department of Labor has confirmed that the Outbreak Period will end on May 11, 2023.
Here are some examples:
- COBRA Elections
If a person experiences a qualifying event and is provided a COBRA election notice before the end of the Outbreak Period, the 60-day COBRA election period begins on July 10, 2023, and ends on September 8, 2023. For qualifying events that occur on or after July 10, 2023, the standard 60-day election period will begin from the date the election notice is provided.
- COBRA Payments
If a person elects COBRA before the end of the Outbreak Period, the initial premium payment date is due 45 days from the end of the Outbreak Period, which is August 24, 2023. Subsequent premium payments would be due according to regular COBRA deadlines (generally, the first day of each month of coverage with a 30-day grace period). For elections that are made on or after July 10, 2023, the standard 45-day initial payment deadline applies.
- HIPAA Special Enrollments
If a person qualifies for a HIPAA special enrollment period due to birth, adoption, marriage, or loss of other coverage, and one of these events occurs before the end of the Outbreak Period, the 30-day special enrollment period begins on July 10, 2023, and ends on August 9, 2023. For special enrollment events that occur on or after July 10, 2023, the standard 30-day special enrollment period applies.
No Time Like the Present
Despite the declaration of the immediate end to the National Emergency, the U.S. Department of Labor (DOL) and the U.S. Department of the Treasury are sticking with their guidance in the form of frequently asked questions (FAQs) that they issued on March 29, 2023, before President Biden signed the law.
To be clear, the April 10, 2023, “early” end of the COVID-19 National Emergency declaration doesn’t mean anything for employer health plans. Continue your planning and tasks with the May 11th deadline in place.
DOL FAQ Source: https://www.cms.gov/CCIIO/Resources/Fact-Sheets-and-FAQs/Downloads/FAQs-Part-58.pdf