Question: We understand that, because of the COVID-19 pandemic, participants in our self-insured ERISA-compliant group health plan must be given more time for certain actions — such as submitting claims and appeals and enrolling during a special enrollment event. We're also under the impression that, as plan administrator, our company has some leeway in furnishing certain notices and documents. Are these extensions still in effect? And how will we know when they end?
Answer: Various health-plan-related deadlines have been extended because of the COVID-19 crisis. Joint guidance from the U.S. Department of Labor and IRS extends many deadlines by specifying that the "outbreak period" — which began on March 1, 2020, and will end 60 days after the announced end of the COVID-19 "national emergency" — is to be disregarded for specified purposes.
This extension applies to HIPAA special enrollment periods, multiple COBRA deadlines, and certain claims and appeals deadlines for participants. In addition, group health plans and responsible plan fiduciaries won't be treated as having violated ERISA if they act in good faith and furnish any notices, disclosures or documents that would otherwise have to be furnished during the outbreak period "as soon as administratively practicable under the circumstances." The deadline for furnishing advance notice of modifications to a Summary of Benefits and Coverage has also been extended.
The national emergency for the purposes of the pandemic refers to President Trump's declaration of a national emergency as of March 1, 2020. Once an end date to the national emergency is announced, the outbreak period will end 60 days after that date unless, as permitted by guidance, the agencies announce a different end date for purposes of these extensions. Other extensions, not defined with reference to the outbreak period or the national emergency date, have already expired. These include extended periods for making Health Savings Account rollovers and the extended deadline for filing Form 5500.
Keep in mind that, for some COVID-19-related coverage mandates (for instance, mandated diagnostic tests), the applicability period is defined with reference to the public health emergency declared by the Department of Health and Human Services (HHS) as of January 27, 2020. HHS public health emergency declarations are generally effective for 90 days but may be shortened or extended. The most recent HHS renewal, announced on October 2, 2020, took effect as of October 23, 2020.
The bottom line is that different COVID-19-related guidance may specify different end dates, and the timing is still in flux. In light of optimistic news about vaccines, one hopes we'll see pronouncements about the end of the national emergency and the public health emergency sometime in 2021. In the meantime, work with your benefits advisors to stay abreast of guidance that otherwise extends, terminates or modifies deadline relief.
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