The White House announced that President Biden will extend the COVID-19 national and public health emergencies one final time. With that announcement, the President stated the intention that this will be the last extension. The termination date is expected to be May 11, 2023.
The White House indicated that the final extension is intended to ensure an orderly wind-down of key processes that states, healthcare providers, and patients have relied on throughout the pandemic.
Public Health Emergency Requirements
The COVID-19 Public Health Emergency designation was made by the Department of Health and Human Services on April 21, 2020. COVID-19 legislation contingent on the public health emergency requires that group health plans must:
- Provide coverage for COVID-19 testing and diagnosis at no cost to plan participants
- Provide coverage for COVID-19 vaccines at no cost (for both in-network and out-of-network providers)
After the public health emergency ends, plans will be able to make decisions about whether to continue, change, or terminate the free testing and diagnosis benefits that were mandated during the COVID emergency period. Notably, both coverage for 8 home testing kits under health plans and the government’s free COVID test program will be terminated when the public health emergency ends. This means that employees will no longer have ready access to free COVID test kits.
COVID-19 vaccinations will continue to be free for participants of group health plans even after the public health emergency ends. Under the ACA, vaccines are considered preventive care, which must be covered at no cost.
National Emergency Requirements
The COVID-19 National Emergency is a separate designation that was made by Executive Order. Recall that this impacts a number of employee benefit tolling periods for plan participants, COBRA-qualified beneficiaries, and employers. Specifically, the following deadlines are extended for one year from the date the individual was first entitled to the extension relief or 60 days after the end of the National Emergency.
- COBRA Elections. The 60-day deadline for electing COBRA coverage.
- COBRA Premium Payments. The 45-day (initial) and 30-day (subsequent monthly) COBRA premium payment deadlines.
- COBRA Notifications (by Employee to Employer). The 60-day deadline by which individuals must notify the plan of certain COBRA-qualifying events (such as a divorce or a child losing eligibility as a dependent under the plan) or a Social Security Administration determination of disability.
- COBRA Notifications (by Employer to QB). The 14-day deadline to provide a COBRA election notice to qualified beneficiaries or the 44-day (14+30 days) deadline for employers who are plan administrators.
- HIPAA Special Enrollment. The 30-day deadline (or 60-day deadline, in some instances) to request enrollment in a group health plan.
- Benefit Claims and Appeals. The plan deadlines by which participants may file a claim for benefits and the deadline for appealing an adverse benefit determination. This includes extensions of claims filing deadlines for health FSAs.
- External Review. The 4-month deadline by which a claimant must request an external review of a final determination on appeal.
After the national emergency ends, these relaxed deadlines will revert to their original form.
While there is no immediate action required, employers should consider the following three items:
- Employers will want to look ahead and consider whether they want to retain, change, or terminate entirely the “free coverage” provisions that were required for COVID-19 testing and diagnosis. If coverage changes are made, communications will be required to all plan participants, and plan documents will need to be updated.
- Many employers have benefited from the relaxed COVID deadlines. It will be important to review internal procedures to confirm that COBRA notice procedures are operating within the regular deadlines after the national emergency ends.
- Many employees and qualified beneficiaries have enjoyed the relaxed deadlines, especially as they relate to electing and paying for COBRA coverage and adding new dependents to health plans. Employers should provide communications to employees and qualified beneficiaries to reiterate that deadlines will revert to the “regular” timing after the national emergency ends.