On April 10, 2023, President Biden signed a congressional resolution ending the US national emergency to respond to the COVID-19 pandemic weeks before it was set to expire alongside a separate public health emergency which is scheduled to end May 11, 2023. On March 29, 2023, FAQs were issued by the Department of Labor (DOL), Health and Human Services (HHS) and the Treasury (collectively, the Departments) relating to the end of the public health emergency and national health emergency.
Once the public health emergency ends, medically indicated COVID-19 testing will no longer be required to be covered at no cost. Health plans can, but are not required to, cover these items at no cost. Note any change to the current benefit might require communication such as through an SPD or SMM. The COVID-19 vaccine will still need to be covered as an in-network preventive service by non-grandfathered plans; out-of-network coverage of the vaccine will not be required unless there are no in network facilities to administer the vaccine.
The relief that came about as a result of the COVID-19 pandemic for qualified high deductible health plans (HDHP) with a health savings account (HSA) will not be affected by the end of the public health emergency. Specifically, an HSA compatible plan can continue to cover COVID testing and treatment prior to satisfaction of the HSA minimum deductible. This relief will remain in effect until further guidance is issued. The Internal Revenue Service and Treasury are looking at updated guidance.
The outbreak period authorized during the national emergency provides for a disregarded period for certain employee benefit actions. Once the outbreak period ends, sixty days following the end of the national emergency, the following will no longer be suspended:
- Election period coverage for COBRA continuation coverage
- Premium payment period
- HIPAA special enrollment period
- Date for individuals to file a benefit claim, appeal an adverse decision or seek external review
One of the special enrollment opportunities available under HIPAA arises when Medicaid or CHIP coverage is lost. Health plan sponsors should be aware there could be an increase in requests for this special enrollment. This could occur because the end of the PHE might result in loss of Medicaid eligibility for some. Be aware an individual has at least sixty days to request this special enrollment. This special enrollment opportunity applies to employee and their dependents if:
- The employee or dependent is covered by a Medicaid plan or a state CHIP plan;
- The coverage is terminated as a result of losing eligibility for coverage; and
- The employee and dependent are eligible to enroll in the employer’s group health plan.
Health plan coverage should start no later than the first day of the calendar month after the plan receives a special enrollment request.