Tri-Agencies Provide FAQ Guidance for Group Health Plans in Anticipation of End of Public Health Emergency and National Emergency

During the COVID-19 Public Health Emergency (PHE) and National Emergency, numerous requirements were introduced for group health plans, which were generally aimed at ensuring individuals did not forgo testing or treatment for COVID-19 because they could not afford to pay for such services.

President Biden has announced that both emergencies will end on May 11, 2023. In order to clarify how group health plan requirements will change going forward, the tri-agencies (IRS, DOL, and HHS) have issued FAQs to explain the impact of the end of the PHE and National Emergency. The FAQs address numerous questions, including the following:

Cost Sharing for COVID-19 Diagnostic Testing

The Families First Coronavirus Response Act (FFCRA) required group health plans to provide COVID-19 diagnostic testing (items and services) without imposing any cost sharing requirements during the PHE. Following the end of the PHE, plans will no longer be required to provide testing without cost sharing, but the agencies encourage plans to continue to provide this coverage. The departments also encourage plans to notify participants if they will stop providing such coverage without cost sharing.  

Coverage for COVID-19 Preventative Services

The Coronavirus Aid, Relief and Economic Security (CARES) Act required group health plans to cover, without imposing any cost sharing requirements, qualifying coronavirus preventative services, including immunizations.  Following the end of the PHE plans will still be required to provide coverage for COVID-19 vaccines without cost sharing. 

Extension of Certain Time Frames

The IRS and DOL issued the Notice of Extension of Certain Timeframes for Employee Benefit Plans, Participants and Beneficiaries Affected by the COVID-19 Outbreak (the Joint Notice), in May 2020. The Joint Notice specified that for a period of up to a year or 60 days after the end of the National Emergency (the Outbreak Period) certain deadlines would be disregarded, including certain special enrollment deadlines, various COBRA deadlines, and claims appeal deadlines. Because the National Emergency will end on May 11, the Outbreak Period will end on July 10, 2023, and deadlines that were delayed can resume. However, the departments noted that group health plans are not prevented from allowing longer timeframes for employees, participants, and beneficiaries to complete certain actions, and plans are encouraged to do so. The FAQs also provided several examples to illustrate how the deadlines will resume.

Benefits for COVID-19 Testing and Treatment and HSAs

The IRS issued Notice 2020-15 in March 2020, which permitted HDHPs to reimburse COVID-19 testing and treatment prior to the deductible being met without impacting HSA eligibility. The IRS has indicated they are still reviewing this guidance and will determine if it is appropriate to maintain this position. They have confirmed that Notice 2020-15 will continue to apply until any further guidance is issued and that they will not make any modifications to this position in the middle of a plan year in order to minimize potential impact to HSA owners.