The End of the COVID-19 Emergency: Considerations for Group Health Plans

On January 30, 2023, the Biden Administration announced their intention to end the COVID-19 National Emergency and Public Health Emergency Declarations on May 11, 2023. The Emergency Declarations began in May 2020 and included temporary rules related to certain group health plan deadlines and coverage of COVID-19 tests and vaccines.

As the May 11* date approaches, followed by the “Outbreak Period” that extends for 60 days after the announced end of the National Emergency (i.e., through July 10, 2023), group health plan sponsors should ensure they are familiar with the relevant compliance considerations and prepare for next steps regarding plan operations and related employee communications. In particular, the following aspects of plan administration are impacted by recent changes:

• Deadlines to request a HIPAA special enrollment, elect COBRA, pay COBRA premiums, notify the plan of a COBRA qualifying event, file a claim for benefits, or appeal an adverse benefit determination;
• Mandatory coverage for COVID-19 tests and out-of-network vaccines; and
• Medicaid continuous enrollment provision will end on April 1, 2023, and may cause an influx of mid-year enrollment requests (via HIPAA special enrollment period).

The PPI publication “End of COVID-19 Emergency Declarations: A Guide for Employers” below provides an overview of these changes and related considerations and includes a Sample Employee Communication (Appendix A) to relay the impact of certain group health plan deadlines to employees. (Note that the sample communication is not intended to satisfy any required plan amendment notice regarding changes to covered services under an employer’s group health plan, as those will vary and should be drafted with legal counsel.)

*NOTE: On March 29, 2023, the HHS, the U.S. Department of Labor, and the Department of the Treasury jointly issued Frequently Asked Questions (FAQs) addressing the impact of the end of the Emergency Declarations. Please note that while the Emergency Declarations are currently slated to expire on May 11, 2023, that date is subject to change.