President Biden has announced that both the COVID-19 Public Health Emergency and the related National Emergency, ongoing since March 2020, came to an end on May 11, 2023. As a result, the corresponding Outbreak Period will end 60 days later on July 11, 2023.
Impact on our COBRA and Consumer-Driven Healthplan (CDH) clients
COBRA:
During the National Emergency, the following COBRA deadlines were to be disregarded until the earlier of 1) one year from the date the individual was first eligible for Outbreak Period relief, or 2) the end of the Outbreak Period. Effective July 11, 2023, these deadlines will return to their pre-pandemic timeframes:
- The 60-day window to elect COBRA continuation coverage
- The 45-day period to make the initial COBRA premium payment
- The 30-day period to make subsequent COBRA premium payments
- The 60-day period for individuals to notify the plan of certain qualifying events disability determination
- The deadlines for plan sponsors to provide COBRA election notices (generally days of the qualifying event)
How will this affect participants who currently have an extension of time for meeting any of the above deadlines?
Below are a couple of examples provided by the Department of Labor (DOL) which help address this question:
Example 1 (Electing COBRA)
Facts: Individual A works for Employer X and participates in Employer X’s group health plan. Individual A experiences a qualifying event for COBRA purposes and loses coverage on April 1, 2023. Individual A is eligible to elect COBRA coverage under Employer X’s plan and is provided a COBRA election notice on May 1, 2023.
What is the deadline for Individual A to elect COBRA?
Conclusion: The last day of Individual A’s COBRA election period is 60 days after July 10, 2023 (the end of the Outbreak Period), which is September 8, 2023.
Example 2 (Paying COBRA Premiums)
Facts: Individual B participates in Employer Y’s group health plan. Individual B has a qualifying event and receives a COBRA election notice on October 1, 2022. Individual B elects COBRA continuation coverage on October 15, 2022, retroactive to October 1, 2022.
When must Individual B make the initial COBRA premium payment and subsequent monthly COBRA premium payments?
Conclusion: Individual B has until 45 days after July 10, 2023 (the end of the Outbreak Period), which is August 24, 2023, to make the initial COBRA premium payment. The initial COBRA premium payment would include the monthly premium payments for October 2022 through July 2023. The premium payment for August 2023 must be paid by August 30, 2023 (the last day of the 30-day grace period for the August 2023 premium payment). Subsequent monthly COBRA premium payments would be due the first of each month, subject to a 30-day grace period.
FSA & HRA
During the National Emergency, the following healthcare claims-related deadlines were to be disregarded until the earlier of 1) one year from the date the individual was first eligible for outbreak period relief, or 2) the end of the Outbreak Period. Effective July 11, 2023, these deadlines will return to their pre-pandemic timeframes:
- The deadline to file a benefit claim under a plan’s claims procedure
- The deadline to file an appeal of an adverse benefit determination under the plans claims procedure
How will this affect participants who currently have an extension of time for meeting any of the above deadlines?
Below are a couple of examples which help address this question:
Example 1 (Filing a Claim)
Facts: Employer X sponsors a calendar year FSA plan. Under the terms of the plan, once the plan year ends participants have a 90-day runout period (ending on March 31, 2023) during which claims can be submitted for the plan year. Participant A incurred an FSA eligible expense on July 1, 2022. Due to the COVID-19 relief, the runout period can be disregarded until the earlier of (1) one year (March 31, 2024) from the original claim submission deadline, or 2) the end of the Outbreak Period (July 10, 2023).
What is the deadline for Participant A to submit the FSA claim?
Conclusion: Participant A has until October 8, 2023 (90 days from July 10, 2023) to submit the claim.
Example 2 (Filing an Appeal)
Facts: Participant B submits a claim against his employer’s HRA plan but on January 9, 2023 receives an adverse determination (ex: the claim is denied). Under the terms of the HRA plan, the participant has 180 days to appeal an adverse determination. Due to the COVID-19 relief, the participant can submit his appeal up to 180 days after the earlier of (1) one year from the date of the adverse determination or (2) 180 days after the end of the Outbreak Period.
What is the deadline for Participant B to submit the appeal?
Conclusion: Participant B has until January 6, 2024 (180 days from July 10, 2023) to submit the FSA claim.