The White House has announced that it intends to extend both the national and public health emergencies one more time and then end them both on May 11th, 2023. While this is merely a statement of intent and not a formal declaration of the end of the emergencies, it would likely be very difficult politically for the President to reverse course barring some drastic change in circumstances.
As a reminder, these two emergency declarations affect health plans in different ways:
- The national emergency is declared by the White House; it was first effective March 1, 2020 and has been renewed in one year increments ever since with a current expiration date of March 1, 2023.
It’s the national emergency that determines how long various deadlines for COBRA elections and payments, HIPAA special enrollments, and ERISA claims and appeals are suspended under the COVID Outbreak Period deadline extension guidelines.
- The public health emergency is declared by HHS and has been renewed approximately every three months since early 2020 with a current expiration date of April 11. From a benefits standpoint, the public health emergency is what requires health plans to cover various COVID related services, like vaccines and tests, at no cost.
The Administration intends to extend both deadlines above for a short amount of time to align expiration on May 11 which ensures the previous commitment of a 60-day notice is upheld.
If the May 11 date holds, with respect to the COVID deadline extensions, the Outbreak Period would extend another 60 days beyond the end of the national emergency to July 10, 2023. At this point, any suspended deadlines would begin running as normal. For example, for a COBRA qualified beneficiary who had been offered COBRA sometime between July 11, 2022 and July 10, 2023, their 60 day election period would start up again on July 11, 2023 and would expire on September 8, 2023. Similarly, COBRA payment due dates and grace periods would also resume as of July 11, 2023.
With respect to no-cost coverage of COVID tests and vaccines, expiration of the public health emergency on May 11 would mean that:
- All health plans would no longer have to cover COVID-19 tests and related services, including over-the-counter tests (if plans should voluntarily choose to continue covering these tests, they would be allowed to impose prior authorization requirements and/or start charging for them as of May 12, 2023)
- All non-grandfathered health plans would no longer have to cover authorized vaccines and boosters out-of-network without cost-sharing (however, they would still have to be covered under the mandatory preventive guidelines in-network without cost-sharing)
There is a good chance we will get specific guidance from the agencies before May 11 regarding how the end of the emergencies will affect various guidance tied to those emergencies. It’s possible such guidance will alter our understanding of how the deadline extension will wind down.
We will also be keeping an eye on how the carriers and TPAs respond to the end of the public health emergency. The end of that emergency will allow health plans to start charging cost-sharing for various COVID related goods and services that were required to be provided at no cost during the emergency. We’ll have to wait and see if the carriers/TPAs intend to start imposing such cost-sharing immediately upon the end of the emergency or wait to make changes until plan renewal or some other future date.
We will provide additional guidance on how the end of the COVID emergencies will impact group health plans and what steps employers may need to take as more details become available.
While every effort has been taken in compiling this information to ensure that its contents are totally accurate, neither the publisher nor the author can accept liability for any inaccuracies or changed circumstances of any information herein or for the consequences of any reliance placed upon it. This publication is distributed on the understanding that the publisher is not engaged in rendering legal, accounting or other professional advice or services. Readers should always seek professional advice before entering into any commitments.