Highlights:

• The deadline for the end of the COVID Outbreak Period remains July 10, 2023.
• The end of the Public Health Emergency on May 11, 2023, will end COVID relief legislation requirements.
• The end of the COVID Outbreak Period ends deadline extensions for HIPAA Special Enrollment, COBRA Notice and premium payments, and claims and appeals filing.

Legislation signed by President Biden on April 10 ends the Covid-19 National Emergency immediately, one month earlier than anticipated. The end of the national emergency ends many temporary rules and compliance responsibilities for plan sponsors, insurance carriers, and others that were put into place at the beginning of the Covid-19 pandemic.
 

The Department of Labor (DOL) has informally announced that despite the statutory end of the national emergency being 30 days earlier than expected, to avoid potential confusion and changes to administrative processes already in progress, the deadline of July 10, 2023, will remain the relevant date for the end of the Covid outbreak period.

FAQs (frequently asked questions) released on March 29, 2023, by the DOL, Treasury, and the U.S. Department of Health and Human Services (HHS) provided the outbreak period generally continues until 60 days after the announced end of the Covid National Emergency or another date announced by the DOL, treasury department, and the Internal Revenue Service (IRS).

The legislation does not impact the Public Health Emergency, which is set to end on May 11, 2023. The end of the Public Health Emergency will end Covid relief legislation that required group health plans and insurers to cover Covid-19 diagnostic testing without cost-sharing, prior authorization, or other medical management requirements during the public health emergency. Non-grandfathered plans were also required to cover Covid-19 vaccines without cost-sharing and on an expedited basis.

End of the Covid Outbreak Period

One of the biggest changes for health plan sponsors will be the end of the Covid Outbreak Period. During the outbreak period, deadlines for the Health Insurance Portability and Accountability Act (HIPAA) Special Enrollment, the Consolidated Omnibus Budget Reconciliation Act (COBRA) notice and premium payments, and claims and appeals filing were extended. These deadline extensions end either at the end of the outbreak period or after an individual has been eligible for a deadline extension for a year, whichever is earlier.

Medicaid Eligibility

In response to the pandemic, the Public Health Emergency required states to keep people enrolled in Medicaid in order to continue receiving a temporary increase in the federal share of Medicaid costs. However, the Consolidated Appropriations Act (CAA) of 2023 unlinked the continuous enrollment to the end of the Public Health Emergency but rather ended on March 31, 2023.

The CAA-23 also required a gradual phased down of increased federal funding beginning April 1, 2023. Beginning April 1, 2023, states will be able to terminate Medicaid enrollment for individuals no longer eligible. Many of these individuals, who are eligible for an employer-sponsored health plan, may be entitled to a HIPAA Special Enrollment right due to loss of Medicaid eligibility. Employers should be prepared for possible new mid-year enrollees.

Standalone Telehealth Benefits

During the Public Health Emergency, applicable large employers (ALEs) under the Affordable Care Act (ACA) were allowed to offer standalone telehealth and remote care services to employees who were not eligible under a group health plan offered by the employer. When the Public Health Emergency ends, these plans will once again need to revisit their telehealth eligibility provisions to avoid violating ACA’s market reform provisions.

Note this is different than the interaction of telehealth coverage and health savings accounts (HSA) eligibility. Under the CAA-23, a two-year extension was provided to allow an otherwise eligible HSA individual to remain eligible even if coverage by a telehealth program that provided coverage before the individual reached their deductible.

The end of the national emergency brings yet another change to the administrative procedures adopted during the pandemic. Plan sponsors should begin to prepare for the end of this emergency now by having conversations with their internal team, health insurance carriers, third-party administrators (TPAs), and trusted advisors.

Author Bio

Jesse Hansen is a Senior Employee Benefits Attorney at OneDigital. He collaborates primarily with benefits advisors and employers in the western half of the U.S. to educate and develop practical compliance solutions for employee-sponsored benefit issues.

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