In response to the COVID-19 outbreak, the U.S. government first enacted a National Public Health Emergency in March 2020. Intended to last one year, it has been extended twice. The current extension is scheduled to end in January 2023.
Public health emergency status gives the government special, temporary powers. For example, regulatory agencies can approve drugs and treatments faster than under normal protocols.
Although there is currently no announced plan to extend beyond January 2023, it’s certainly possible. Germany and France have seen a concerning rise in COVID cases. New variants are gaining traction worldwide. As colder weather drives people indoors at home, work, school, and other public places, COVID infections may surge in the U.S.
Impact on Employee Benefit Accounts
Extension of public health emergency status automatically extends the temporary rule changes regarding COBRA, HIPAA, and group health plans (including FSAs and HRAs). Decreed jointly by the Internal Revenue Service (IRS) and the Department of Labor (DOL), these were issued on April 29, 2020.
Benefit Deadlines Affected
Per the rulemaking, the period from March 1, 2020, until 60 days after the end of the National Emergency (the “Outbreak Period”) must be disregarded in tolling the following deadlines:
- COBRA Election Notice Deadlines
The 14-day deadline for the group health plan administrator (or 44 days, where the employer is the plan administrator) to provide a COBRA election notice to qualified beneficiaries.
- COBRA Qualifying Event and Disability Extension Notices Deadline
The 60-day deadline by which qualified beneficiaries must notify the plan of certain qualifying events. These include divorce or legal separation, a dependent child ceasing to be a dependent under the plan’s terms, or a disability determination, among others.
- COBRA Election Deadline
The 60-day deadline to elect COBRA continuation coverage.
- COBRA Premium Payments Deadline
The 45-day (initial payment) and 30-day (subsequent payments) deadlines to timely pay COBRA premiums.
- HIPAA Special Enrollment Period Deadline
The 30-day deadline (in some instances, 60-day) to request enrollment in a group health plan following a qualifying event. Qualifying events include birth, adoption, marriage, loss of other health coverage, or eligibility for a state premium assistance subsidy.
- Benefit Claims and Appeals (group health plans, FSAs, and HRAs) Deadline
The deadline under the plan by which participants may file a claim for benefits (under the plan’s terms). Also, the deadline for appealing an adverse benefit determination.
The agencies clarified in their notice issued on February 26, 2021, that the COBRA tolling period applies on a person-by-person basis. Plan administrators will want to ensure they calculate deadlines correctly.
External Review Provisions
- External Review
The 4 months for the federal external review process for a claimant to file a request for external review. This period may be different for a state external review process.
- Perfecting a Request for External Review
The 4 months (or 48 hours after receipt of an incomplete request notification, if later) for a claimant to perfect an incomplete request for external review.
The above is for informational purposes only and should not be construed as legal advice. Consult your third-party administrator (TPA) or qualified benefits counsel for more information.