Compliance Alert Sample

COVID-19 Emergency Ends As you may be aware, a Public Health Emergency (PHE) was declared on January 31, 2020 and a National Emergency (NE) was declared on March 1, 2020 due to the COVID-19 pandemic. Over the last few years, the emergency declarations had many significant impacts on life in the USA -- too many to list here – as well as impacts on employee group health plans. As of May 11, 2023, the Biden administration ended the COVID-19 Public Health Emergency and the National Emergency. Highlights of health benefit changes resulting from the end of PHE and the NE include… COVID-19 vaccines. COVID-19 vaccines will continue to be covered without cost sharing as a preventive service pursuant to the Affordable Care Act regulations, but the cost of the vaccine will no longer be paid by government agencies. The cost will be picked up by the health plan. After the PHE, group health plans are not required to provide benefits for COVID vaccines delivered by out-of-network providers if the plan can provide vaccines in-network. COVID-19 testing, over the counter and in-office tests. Health plans will no longer be required to cover diagnostic testing without cost sharing and will no longer be required to cover over the counter tests, although they may choose to do so. Recently issued IRS FAQs clarify that high deductible health plans (HDHPs) can continue to cover pre-deductible COVID-19 testing and treatment without affecting eligibility for contributions to a health savings account (HSA). However, the FAQs state this relief will only last until the IRS issues further guidance. Reinstatement of deadlines applicable to benefit plans and participants. Certain deadlines applicable to health and welfare plans were extended for the earlier of (1) 1 year from the date the plan participant became eligible for relief or (2) 60 days after the end of the National Emergency. Some of the deadline extensions included: • The 30- or 60-day Special Election Period to request enrollment in a group health plan; • Claim filing deadlines for health plans; • Deadlines for requesting internal and external appeals for adverse benefit determinations; • COBRA election deadlines;

• COBRA premium payment deadlines. As the National Emergency has now ended, the counters for the previously extended deadlines will be re-instated starting 60 days after May 11, 2023 (that is, on July 10, 2023). Examples of how the re-instatement of some of these deadlines will work can be found here. Telehealth. Most telehealth services will not be affected by the end of the PHE and the NE. This is mostly due to the Consolidated Appropriations Act of 2023 (CAA), passed in December 2022 that included provisions extending many telehealth flexibilities until December 31, 2024. As a reminder, plan sponsors should issue notice of any change or reduction in health benefits, such as any changes related to the above, within 60 days of the change. Action Items: • Sponsors of insured plans may reach out to their insurers to confirm what the insurer will cover with respect to COVID-19 testing and vaccines. • Sponsors of self-insured plans can work with their third-party administrators to determine what COVID-19 testing and vaccine coverage options will be available after the end of the PHE. • Plan sponsors should consider proactively communicating the end of National Emergency and the impact on deadline extensions to plan participants, if applicable. If you have any questions, please contact your EBS account representative. Susan Sonkin, ChFC®, CLU®, CEBS, RHU®, REBC® Compliance Director EBS Employee Benefit Solutions