Q: President Biden announced his plan to end the COVID Public Health Emergency on May 11, 2023. How will the end of the emergency affect my group health plans?
A: When the Public Health Emergency ends, the temporary rules established for group health and ERISA plans will also end. Some of the COVID rules will end immediately, and other rules will end 60 days after the end of the public emergency.
The following COVID-19 rules will end immediately on May 11th:
- COVID-19 testing without cost sharing or prior authorization.
- Groups will no longer be required to provide free diagnostic tests to members.
- COVID-19 vaccines provided out-of-network will be subject to out-of-network rules under preventive care. Plans must continue to cover COVID-19 vaccinations without cost sharing for in-network providers only.
COVID-19 also provided temporary relief, extending deadlines for one year, for certain plan provisions during the Public Health Emergency. These deadlines expire 60 days after the end of the National Health Emergency or on July 10, 2023. Groups will revert to pre-COVID or the standard Department of Labor guidelines. The following deadline relief will end on July 10th:
- COBRA deadlines will return to normal government deadlines. This includes notifying the employee of COBRA rights (14 days), the date an individual election form must be returned (60 days), the date of COBRA payments (initial 45 days and monthly 30 days), the date an individual must notify the employer of a COBRA qualifying event such as divorce or dropping a dependent (30 days).
- Special Enrollment Rights will revert to a group’s normal deadlines of at least 30-day notice by the employee for events including marriage or birth of a child (60 days for the loss of Medicaid or CHIP coverage or after eligibility for premium subsidy).
- Claims and Appeals deadlines will follow the plan and claims deadlines set forth in the plan’s documents.
Groups with a Qualified High Deductible Health Plan that extended the ability for telehealth and other remote care services to be covered before plan deductibles are extended through December 31, 2024. Groups can allow this benefit to continue without jeopardizing the employee’s Health Savings Account eligibility.
Groups may want to refer to the Employer Guide to COBRA, HIPAA Special Enrollment Rights and Claims and Appeal Procedures for the government deadlines and rules.