How Do We Determine COBRA Election and Payment Deadlines at the End of the COVID-19 Outbreak Period?

How Do We Determine COBRA Election and Payment Deadlines at the End of the COVID-19 Outbreak Period?

QUESTION: As required, our company’s group health plan has extended COBRA election and payment deadlines due to the COVID-19 emergency. How do we handle these deadlines once the outbreak period ends?

ANSWER: As you note, certain COBRA deadlines have been extended—but for no longer than one year—by disregarding (tolling) the COVID-19 “outbreak period,” which began March 1, 2020, and is set to end on July 10, 2023. Agency guidance issued in March 2023 provided examples illustrating the effect of the outbreak period’s end on COBRA election and premium payment deadlines:

  • Electing COBRA. If a participant experiences a qualifying event and is provided a COBRA election notice on or before July 10, 2023, the individual’s 60-day period to elect COBRA begins to run on July 10, 2023 (making the deadline September 8, 2023). If the qualifying event occurs after July 10, 2023, there is no extension, and the 60-day period is measured from the date the COBRA election notice is provided. Although not expressly addressed, it appears that if a qualifying event occurs on or before July 10, 2023, and the COBRA election notice is provided after that date, the COBRA election deadline would be measured from the provision of the notice.
  • Paying COBRA Premiums. The guidance provides an example of a COBRA election made on October 15, 2022, retroactive to October 1, 2022. The initial COBRA payment, covering premiums from October 2022 through July 2023 must be made no later than 45 days after July 10, 2023 (i.e., August 24, 2023), with subsequent payments due according to the regular COBRA timeline (the first day of each month of coverage, with a 30-day grace period).

In addition to COBRA deadlines, the end of the outbreak period also affects certain other plan-related deadlines, including those for claims and appeals and HIPAA special enrollments. The agencies have noted that nothing in the Code or ERISA prevents group health plans from continuing to extend deadlines and have encouraged plans to do so—at least for a while—as the outbreak period comes to an end. Keep in mind, however, that any extension beyond what is required should be cleared with plan insurers and stop-loss insurers, as applicable.

Source: Thomson Reuters

Can a Telehealth-Only Plan Continue After the End of the COVID-19 Emergency?

Can a Telehealth-Only Plan Continue After the End of the COVID-19 Emergency?

Question: During the COVID-19 pandemic, we established a telehealth-only plan to provide benefits to individuals who were not eligible for coverage under our regular group health plan. Can we continue to offer this benefit?

ANSWER: During the COVID-19 pandemic, telehealth-only benefits have been exempt from certain requirements that otherwise apply to group health plans. This relief is linked to the COVID-19 public health emergency (PHE), which appears slated to end on May 11, 2023. Once the exemption is no longer available, a telehealth-only plan may continue but it would have to meet those requirements.

As group health plans, telehealth plans must comply with the many rules applicable to group health plans under ERISA, COBRA, HIPAA, and the Affordable Care Act (ACA). The COVID-19 telehealth relief exempts certain plans from the ACA’s prohibition on annual and lifetime limits and its preventive services mandate—but not from other ACA mandates. The relief applies to any arrangement sponsored by a large employer (generally, one with at least 51 employees) that provides solely telehealth and other remote-care benefits and is offered only to employees or dependents who are not eligible for coverage under any other group health plan offered by that employer.

The relief took effect in 2020 and applies for the duration of any plan year beginning before the end of the COVID-19 PHE. If the PHE ends on May 11, 2023, a calendar year telehealth-only plan could remain covered by the exemption until the end of 2023. But if the plan year is, for example, June 1–May 31, the relief applies only until the end of the current plan year on May 31, 2023; as of June 1, 2023, that plan would have to comply with the preventive services mandate and the prohibition on annual and lifetime limits.

Source: Thomson Reuters

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