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Health & Welfare Plans Newsletter

March 29, 2023


[Official Guidance]

Text of Agency FAQs About FFCRA, CARES Act, HIPAA Implementation, Part 58: End of the COVID-19 National Emergency and Public Health Emergency

"The Departments are issuing these FAQs to clarify how the COVID-19 coverage and payment requirements under the FFCRA and CARES Act will change when the PHE ends. Specifically ... plans and issuers are not required to provide coverage for items and services related to diagnostic testing for COVID-19 that are furnished after the end of the PHE, and if they provide such coverage, they may impose cost-sharing requirements, prior authorization, or other medical management requirements for such items and services."

8 Q&As covering:

  • COVID-19 diagnostic testing;
  • Rapid coverage of preventive services and vaccines for coronavirus;
  • Extension of certain timeframes for employee benefit plans subject to ERISA and the Code, participants, and beneficiaries affected by the COVID-19 outbreak;
  • Special enrollment in group health plan and group or individual health insurance coverage after loss of eligibility for Medicaid or Children's Health Insurance Program (CHIP) coverage or after becoming eligible for premium assistance under Medicaid or CHIP;
  • Benefits for COVID-19 testing and treatment and health savings accounts (HSAs)/high deductible health plans (HDHPs).

Also available:  Medicaid-CHIP SEP Options Flyer, for individuals who may lose their Medicaid or Children's Health Insurance Program (CHIP) coverage after March 31, 2023.  MORE >>

Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS]

[Guidance Overview]

What Does the End of the COVID-19 Public Health Emergency Mean for Health Benefits?

"After the end of the COVID-19 public health emergency, group health plans will no longer be required to cover COVID-19 diagnostic testing (including over-the-counter tests) at no cost to individuals.... While many plans must continue to cover COVID-19 vaccines at no cost to employees from an in-network provider, the requirement to cover COVID-19 vaccines out-of-network will generally lapse after the end of the COVID-19 public health emergency.... The end of the COVID-19 national emergency also means that the extensions of certain time frames for employee benefit plans are expected to end on July 10, 2023 (60 days after the end of the national emergency).... Many employees and dependents who are currently enrolled in Medicaid or CHIP coverage may lose eligibility for that coverage after March 31, 2023."  MORE >>

Employee Benefits Security Administration [EBSA], U.S. Department of Labor [DOL]

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BenefitsLink® Retirement Plans Newsletter, ISSN no. 1536-9587.

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