News Archive

"The IRS's recent guidance on COVID-19 testing and treatment marks another (time-limited) eligible expense that plan sponsors will need to track as they monitor the scope of permissible expenses that can be covered under an HDHP before a participant satisfies the IRS minimum deductible."  MORE >>

"For calendar year plans, this means that reduced-cost COVID-19 testing and treatment can be covered by an HDHP through Dec. 31, 2024. For non-calendar year plans, the relief applies through the plan year that ends in 2024."  MORE >>

"[Notice 2023-37] puts a deadline on the relief described in Notice 2020-15, issued in March 2020, by saying it applies only to plan years ending on or before Dec. 31, 2024."

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"[T]his notice modifies prior guidance regarding benefits relating to testing for and treatment of COVID-19 that can be provided by a health plan that otherwise satisfies the requirements to be a high deductible health plan (HDHP) ... Specifically, this notice provides that the relief described in Notice 2020-15 ...  applies only with respect to plan years ending on or before December 31, 2024.

"This notice also clarifies ... that the preventive care safe harbor ... does not include screening (i.e., testing) for COVID-19, effective as of the date of publication of this notice [June 23, 2023]. This notice also provides that items and services recommended with an 'A' or 'B' rating by the United States Preventive Services Task Force (USPSTF) on or after March 23, 2010, are treated as preventive care for purposes of section 223(c)(2)(C), regardless of whether these items and services must be covered, without cost sharing, under Public Health Service Act section 2713."  MORE >>

"Eligible businesses may use the funds to reimburse for [supplemental paid sick leave (SPSL)] provided between January 1, 2022, and December 31, 2022. Businesses will be required to provide proof of employee payroll records that verify all SPSL provided by the business was pursuant to the state requirements"

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"In addition to the HFWA's original covered absences, once effective, the amended list of covered reasons for use of paid sick leave will include absences related to bereavement leave and certain closures or evacuations due to inclement weather, loss of power, or other unexpected events. The SB 23-017 amendments go into effect on August 7, 2023."

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"In response to the anticipated ending of the outbreak period on July 10, 2023, the Massachusetts Division of Insurance, on April 10, 2023, issued Special Bulletin 2023-09 to ... commercial health insurers, to address the implications of the ending of the National Emergency with respect to COBRA.... This Bulletin does not apply to self-insured group health plans, and it is still too early to determine the extent to which regulators in other jurisdictions will take similar action."  MORE >>

"Prior to July 10, 2023, plan sponsors should begin to review and revise their health plan design and related documents with their plan administrators and legal counsel. To the extent that plan documents and participant communications were modified to reflect the temporary National Emergency deadlines, plan sponsors should evaluate whether the documents need to be revised to reflect the end of the National Emergency."

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"This slide deck describes agency guidance about which COVID-19 coverage mandates will expire once the public health emergency ends on May 11, and how to calculate key plan and participant deadlines before and after the outbreak period ends on July 10. The slides also describe employer actions that the agencies encourage but do not require, such as steps to lessen the impact of Medicaid redeterminations on employees and their families."

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"New laws in Arkansas and Tennessee allow for family leave insurance. Illinois now requires all workers to earn paid leave they can use for any reason, starting in 2024. A recent San Francisco ordinance institutes paid military leave, while changes to existing paid leave laws occurred in Puerto Rico and two Minnesota cities.... Telehealth access gained traction in several states, including Idaho, Utah, Vermont, Washington and Wyoming. More than a half dozen states passed prescription drug laws ... Illinois and New York were among states issuing insurance coverage mandates."

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"After the Public Health Emergency. Health plans can enforce network restrictions, impose cost-sharing, apply medical management techniques such as prior authorization, and even stop covering COVID tests altogether. Plan sponsors may take any of these actions immediately or wait until the end of the current plan year or other future date. Plans continuing full coverage should consider any impact on mental health parity of the plan's financial requirements."  MORE >>

"[C]ertain time periods and dates for special enrollment under [HIPAA], COBRA continuation coverage, and internal claims and appeals and external review [were] disregarded when determining the due dates for certain elections and other actions by employee benefit plans subject to ERISA and the Internal Revenue Code during the COVID-19 National Emergency. Retirement plan elections were also impacted by the Disregarded Periods."

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"Plan administrators should review prior communications sent to qualified beneficiaries regarding the tolling of COBRA election and premium payment periods and provide updated communications to the extent necessary. Given that deadlines are calculated on an individual basis, a general notice describing the end of the COVID-19 pandemic and the impact on COBRA deadlines may be preferable in some situations ... Administrative processes should also be reviewed and adjusted ... to avoid unintentionally extending COBRA deadlines beyond the end of the COVID-19 emergency."

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"[FAQs Part 58] make clear that high deductible health plans (HDHPs) can continue to cover pre-deductible COVID-19 testing and treatment without affecting eligibility for a health savings account (HSA). However, the FAQs state that this relief will only last until the IRS issues further guidance."

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"As coverage requirements change, [this article covers]: [1] Over-the-counter and in-office tests; [2] COVID-19 vaccines; [3] Standalone telehealth benefits; [4] Noncompliance relief for the Mental Health Parity and Addiction Equity Act; [5] Employee assistance programs; [6] Reinstatement of deadlines applicable to benefit plans and participants Communication and plan-related notices."

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"[E]mployers are no longer required to provide to non-exempt employees who have or are suspected of having COVID-19 the five-day special paid leave due to emergencies declared by the Government of Puerto Rico[.]"

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"The agencies have encouraged plans to continue providing coverage for COVID-19 testing beyond the PHE at no cost to participants. However, plans may choose not to cover the tests or to cover them while imposing cost-sharing or out-of-network limitations. Unlike the diagnostic testing coverage requirement, the requirement to provide COVID-19 preventive services (vaccines) is not limited to the duration of the PHE."

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"[G]roup health plan sponsors should consider ... [w]hether the group health plan will continue to cover out-of-network COVID-19 vaccines at no cost, or at all. Insured plans should reach out to their insurers to confirm what the insurer has decided to cover. Self-insured plans should work with their third party administrators to determine what coverage options are available after the end of the PHE."

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"[DOL] and IRS have informally commented that the 'outbreak period' will end on July 10, 2023.... [This article] recaps the implications on employer-sponsored group health plans of the end of the national emergencies under the NEA and the Stafford Act."  MORE >>

"[This] Fact Sheet [provides] an update on current flexibilities enabled by the COVID-19 emergency declaration and how they will be impacted by the end of the COVID-19 PHE on May 11.... The Administration's continued response to COVID-19 is not fully dependent on the emergency declaration for the COVID-19 PHE, and there are significant flexibilities and actions that will not be affected when we transition from the current phase of our response on May 11.... Many COVID-19 PHE flexibilities and policies have already been made permanent or otherwise extended for some time, with others expiring after May 11."

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"[1] Modified deadlines ... [1] Qualifying event notice ... [3] Sending COBRA election notices ... [4] COBRA election period ... [5] First COBRA payment due date ... [6] COBRA payment due date ... [7] Claim filing deadline ... [8] Internal appeal deadline ... [9] External appeal deadline ... [10] Special enrollment ... [11] Plan sponsor/administrator considerations ... [12] Document changes."  MORE >>

"[T]his report: [1] provides an overview of the current coverage and payment of COVID-19 vaccines and treatments across payers; [2] identifies expected gaps in coverage after the end of U.S. Government-provided supply and key considerations for coverage determinations post-PHE; and [3] presents estimates on expected savings and spending offsets for a select set of COVID-19 products that have been demonstrated to reduce COVID-19-related hospitalizations." [Updated May 2023]

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"[It] is the DOL's position that FAQs Part 58 announced the end of the National Emergency as July 10, 2023.... [G]roup health plans and issuers (i.e., insurers) are either required or 'encouraged' to provide notice of COVID-19-related benefits coverage changes to plan participants, and in some cases beneficiaries and other enrollees ... [T]he Outbreak Period deadline extensions ... will cease to apply effective 60 days after the end of the National Emergency.... [T]he Departments note that nothing prevents a plan or issuer from permitting longer timeframes to provide notices and elections under these provisions and plans are encouraged to do so."

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"Though the vast majority of people with private health coverage will continue to have coverage for COVID-19 tests ordered or administered by a clinician, those tests may soon be subject to cost sharing, quantity limits, and prior authorization requirements.... [T]he median price of a COVID-19 test in an outpatient clinical setting was $45 in 2021 among people with large employer-based health coverage ... [T]he median discounted hospital-based self-pay rate was $51 for a COVID-19 antigen test and $91 for a PCR test.... [R]ecent prices for at-home rapid COVID-19 tests average about $11 per test."  MORE >>

"Most respondents (46%) indicated that they would not continue coverage for OTC COVID-19 tests and testing-related services.... Twenty-one percent of respondents said they are going to cover testing and testing-related services indefinitely, whereas 14% indicated they would only continue coverage for a certain period of time.... 19% of respondents stated they have yet to decide whether they are going to cover testing once the PHE is lifted."

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