In the wake of COVID, both the Department of Labor (DOL) and the Health and Human Services (HHS) declared states of emergency and relaxed certain employee benefit deadlines. These states of emergency declarations, the extensions themselves, and the accompanying plan requirements can be confusing. This article outlines the two different COVID emergency declarations and the current states of the various extensions.
How do National Emergency extensions work?
Numerous employee benefit plan deadlines were extended by the DOL when the National Emergency due to COVID was declared on March 1, 2020. A National Emergency declaration continues until:
- The emergency is not continued by the president (after the default one-year period)
- The president terminates it
- A joint resolution of Congress terminates it.
The COVID National Emergency was most recently continued by the President on March 1, 2022. This means that absent a further continuation or early termination, the current COVID National Emergency will end on February 28, 2023.
DOL Deadline Extensions
The following DOL deadlines were extended pursuant to the National Emergency declarations:
- The COBRA 60-day election period, COBRA payment due dates, and COBRA deadlines to notify the plan of a qualifying event or new disability.
- The 30-day or 60-day window to submit a HIPAA special enrollment request.
- The deadline to file, appeal or request an external review of a claim.
The above extensions will end at the end of the defined “Outbreak Period” and runs until the earlier of:
- 60 days after the announced end of the COVID National Emergency
- One year from the date an individual is first eligible for deadline relief
Employer Action Items: Plan sponsors must ensure these deadline extensions are followed for all participants and COBRA beneficiaries. In addition, eligible individuals will need to be tracked to ensure their personalized one-year deadline is followed. Lastly, participant communications should be reviewed and updated to reflect the reversion to regular deadlines.
How do Public Health Emergency extensions work?
In addition to the president’s declaration of a National Emergency, the HHS also declared a Public Health Emergency due to COVID in January 2020. Unlike the National Emergency, a Public Health Emergency may only exist in 90-day increments before it must be extended.
The current COVID Public Health Emergency was extended by the HHS on July 15, 2022. This would mean, absent a further extension, the COVID Public Health Emergency will expire on October 13, 2022. However, HHS has announced it will provide at least 60 days advance notice prior to the end of the Public Health Emergency in order for plan sponsors to prepare.
HHS Deadline Extensions
The HHS Public Health Emergency required plans to:
Employer Action Item:
- Cover COVID-19 diagnostic testing and related services without cost sharing, prior authorization, or other medical management requirements
- Cover COVID-19 vaccines and boosters (including from out-of-network providers) without cost sharing, prior authorization, or other medical management requirements
The CARES Act provisions will continue to require plans to cover COVID vaccines from in-network providers at no cost as a preventive measure. However, in looking ahead to when these provisions will end, plan sponsors should address the following:
- Consider whether to continue covering COVID testing and out-of-network vaccines without cost sharing with participants.
- Review/update plan documents and participant communications
- Send communications to participants about any changes in benefits.
CARES Act TeleHealth Provisions
While not connected to either of the above emergency declarations, the CARES Act temporarily permitted telehealth services for individuals covered under HDHP plans prior to reaching the statutory deductible. This enabled first-dollar coverage of these services without jeopardizing HSA eligibility for plan years beginning on or before December 31, 2021.
Effective April 1, 2022, Congress extended this first-dollar coverage relief
through December 31, 2022.
While many hope that this relief will become permanent, such a change would require legislative action. As such, employers should plan for this provision to sunset at the end of the year.
Employer Action Item:
Participants covered under HDHP policies likely have gotten used to this first-dollar telehealth coverage being provided under their plan. A review/update of plan documents and communication to plan participants that this provision will expire at the end of this year will be important.