Executive Declaration Phasing Out COVID Policy
Senior Compliance Attorney
Please note there is some debate whether the date of the resolution, April 10, 2023, is the actual end of the National Emergency or if it remains May 11, 2023. At this time, there is no clear guidance on which date should be used to determine the end of the outbreak period for purposes of the deadline extensions. If you have a deadline extension situation for events that occurred post June 10, 2022, please contact your M3 Account Team or your benefits counsel.
On January 30, 2023, the Executive Office of the President of the United States issued a “Statement of Administration Policy” declaring the discontinuation to the COVID-19 National Emergency (NE) and Public Health Emergency (PHE) effective May 11, 2023. The end of these emergency periods will have an impact on employer sponsored health plans as follows:
Group Health Plan Deadline Extensions
Federal and state governments have created regulations and requirements for group health plans during the pandemic. Those requirements have focused on deadline relief for the following items:
- COBRA: 60 day election period, premium due dates and notification of qualifying event or determination of disability
- HIPAA Special Enrollment: 30 day enrollment period (or 60 day period under CHIPRA)
- Benefit Claims procedure
- Appeal for an adverse benefit determination
- Request for external review or final internal adverse benefit determination
The original guidance extended these time periods until the end of the National Emergency plus 60 days, which was deemed the end of the “outbreak period”.
Additional guidance issued in 2021 applied an extension of 1 year from the date of the event OR until the end of the “outbreak period”, whichever was first.
The scheduled end of National Emergency is set for May 11, 2023 which will put an end to these deadline extensions on July 10, 2023.
COVID Testing and Vaccines
During the Public Health Emergency, health plans were required to cover COVID-19 tests without applying any cost-sharing. Once the PHE ends, first dollar coverage of the tests will not be required.
In addition, during the PHE non-grandfathered plans were required to cover COVID-19 related preventive services, including vaccines, without imposing cost-sharing and without relation to whether a provider was in-network or out-of-network. Once the PHE ends, provision of the vaccines can be limited to in-network providers.
Employers should take note of the May 11, 2023 ending date to the NE and PHE and make any required adjustments to their internal practices regarding the deadline extensions. In addition, employers should take note of the changes to group health plan provisions related to COVID-19.