Read More

COVID-19 National Emergency and Public Health Emergency Set to End on May 11

President Biden signed legislation ending the National Emergency earlier than initially expected and discussed in the article below. Please review our latest blog post on this.

On January 30, 2023, the Biden Administration announced its intention to end both the COVID-19 National Emergency and Public Health Emergency on May 11, 2023.

Ending both the National and Public Health emergencies bring to an end many temporary rules and compliance responsibilities for plan sponsors, insurance carriers, and others put into place at the beginning of the COVID-19 pandemic.

End of the COVID Outbreak Period

One of the biggest changes for health plan sponsors will be the end of the COVID Outbreak Period (Outbreak Period), which we now know is set to end on July 10 (60 days after the end of the National Emergency). During the Outbreak Period, deadlines for HIPAA Special Enrollment, 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. For many plan participants, July 10 will be their final opportunity to take advantage of these extended deadlines.

COVID-19 Testing and Vaccine Cost Sharing

The Public Health Emergency required that health plans cover all COVID-19 diagnostic tests, vaccinations, and treatment without cost sharing. The end of the Public Health Emergency means health plans may now require participants to pay deductibles, copayments, or coinsurance when they receive COVID-19 tests and treatments. Plans can also have cost-sharing for COVID vaccinations given by out-of-network providers. Cost-sharing prohibitions still apply to COVID-19 vaccinations received from in-network providers.

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. The end of the Public Health Emergency means the end of increased federal funding. Therefore, many states are expected to begin reevaluating Medicaid eligibility, meaning many Medicaid participants could lose coverage. Many of these participants may also be eligible for an employer-sponsored health plan. Their loss of Medicaid eligibility entitles them to a HIPAA Special Enrollment period, meaning employers should be prepared for new mid-year enrollees on their health plans.

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 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 and Public Health emergencies brings yet another change to the administrative procedures adopted during the pandemic. Plan sponsors should begin to prepare for the end of these emergencies now by having conversations with internal team, health insurance carriers, TPAs, and trusted advisors.

If you have questions about what the end of these emergencies mean for your health plan, contact your OneDigital consultant. Discover more compliance updates employers need to know by registering for the Q4 Compliance Recap.