Massachusetts Adds Special Enrollment Period for Loss of COBRA Coverage

The end of the COVID national emergency and its accompanying Outbreak Period continues to bring changes to health plan compliance. The latest change comes from the state of Massachusetts, which recently issued Special Bulletin 2023-09.

The Special Bulletin states that insurers and health plans in the state must allow for special enrollment when an otherwise eligible individual loses COBRA coverage. This new rule is set to expire on November 23, 2023.

What plans must comply with the Special Bulletin?

The Special Bulletin applies to all fully insured group health plans in Massachusetts. It does not apply to self-insured plans. At this time, it is unknown whether out of state employers with Massachusetts-based employees will have to comply.

What if COBRA was voluntarily terminated?

Massachusetts has determined that any loss of COBRA coverage, including termination for non-payment or voluntary termination, will trigger a special enrollment event that allows individuals to request special enrollment within 60 days after their loss of COBRA coverage. This differs from the federal rules, which allow for a special enrollment event if COBRA coverage is exhausted, but not if it is voluntarily terminated.

Have COBRA election deadlines been extended?

No. The end of the COVID Outbreak Period on July 10, 2023 also ends the tolling and extension for COBRA election and payment timelines and HIPAA special enrollment. Under federal law, an otherwise eligible individual who loses COBRA coverage will have 60 days to enroll in their employer’s group health plan.

Massachusetts employers with fully insured plans should speak with the carrier to make sure administrative procedures are already in place to comply with the Special Bulletin. Employers should also meet with internal teams to determine which, if any, otherwise eligible employees may be joining their health plan this year. As always, if you have any questions about the Special Bulletin and how it impacts your health plan, contact your OneDigital consultant.

You can stay up to date on state-level legislative changes by monitoring our Compliance Confidence blog.