What happens when COVID emergencies end?

By Fingercheck Marketing
April 6, 2023

In 2020, the federal government created the Coronavirus Aid, Relief and Economic Security Act (or CARES Act), designed to provide fast, direct economic assistance to Americans who were negatively impacted by the COVID-19 pandemic.

President Joe Biden announced plans to end the public health emergency on May 11, 2023. This decision, announced on Jan. 30, 2023, will affect employer-sponsored benefits for certain coverages, reimbursements and timelines. 

The many laws and regulations passed after the 2020 pandemic created temporary rules tied to the end of the emergency action. Employers now will face significant tasks and obligations to amend the changes from the past three years. 

The most significant areas that employers must tackle are free coverage that will end and required deadlines that will start. Do you need help? Sign up today for Fingercheck 360 Plus.

Free coverage that will end

The Families First Coronavirus Response Act (FFCRA) required health plans to cover the cost of COVID-19 testing and related services without cost-sharing. The CARES Act expanded the FFCRA by adding vaccinations from out-of-network providers and over-the-counter tests.

When the emergency ends in May, this required no-cost coverage of testing and related services also will end. 

If you are a business owner with a fully insured plan, you should speak to your carrier about your options if you want to continue this coverage without cost-sharing. Your state’s Department of Insurance should offer guidance to carriers on when cost-sharing will resume, but self-funded groups may have more flexibility to continue to offer testing and related services without cost-sharing. 

Under the Affordable Care Act’s preventative services requirement, fully approved COVID-19 vaccines will remain covered — without cost — by in-network providers. A reduction in coverage will require a 60-day advance notice to affected employees.

Standalone telehealth benefits are also affected. Employees who were ineligible for their employer’s health plan were able to enroll in standalone telehealth benefits. The relief applies for the plan year that begins on or before the end of the emergency. An employer providing standalone telehealth will not be able to continue the coverage past the end of the current plan year and should review their policy to modify the language for standalone coverage. A reduction in coverage requires sending a notice to affected employees 60 days prior to the plan’s year-end date.

Required deadlines that will start

The outbreak rules issued in May 2020 are connected to the provisions of the past three years. The outbreak period continues until 60 days after the end of the national emergency. The outbreak rules had granted extensions to several key deadlines related to COBRA, claim submission, appeal processes and special enrollment periods.

In 2021, the Employee Benefits Services Administration issued a notice providing guidance and clarity for employers. This notice also stated that the maximum period a deadline may extend is the earlier of one year from the date an original deadline would begin or 60 days after the end of the outbreak period. This one-year period is known as tolling.

Employers must track each employee’s tolling period as May 11 nears. If an employee normally has 60 days to elect COBRA continuation coverage, then that 60-day deadline would not begin until one year and 60 days later or 60 days after the outbreak period.

The tolling period has been a point of confusion for employers and may be more confusing as the outbreak period now has a planned end date of May 11, 2023. Here’s an example to illustrate the elections:

Employee A’s benefits were terminated on December 31, 2022. Traditionally, Employee A would have until March 2023 to elect COBRA.

But the relief states the 60-day countdown would not begin until the earlier of one year (December 2023) or July 10, 2023 (60 days after the end of the outbreak period).

Since the outbreak period end date is planned for May 11, 2023, which is earlier than the one-year tolling, Employee A must make their COBRA election by September 20, 2023.

On Feb. 9, 2022, the Department of Health and Human Services (HHS) provided a roadmap outlining what may and may not be affected by the end of the emergencies. HHS also indicated it will continue “to review the flexibilities and policies implemented during the COVID-19 PHE (public health emergency) to determine whether others can and should remain in place, even for a temporary duration, to facilitate jurisdictions’ ability to provide care and resources to Americans.”

As a best practice, employers and plan sponsors should continue monitoring federal and state government resources. Employers might need to revise plan documents and provide new notifications to employees when coverage is changed or eliminated.

Confused? We get it. The end of the CARES Act seems challenging. That’s where HR Concierge can help. 

This article originally appeared on the Mineral blog and is adapted with permission.

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