Earlier this year, President Biden announced his intention to end the COVID-19 public health emergency (PHE) and National Emergency (NE) on May 11, 2023, and the U.S. Department of Health and Human Services confirmed their intent to do the same with respect to the PHE. Given the May 11th end of the NE, the COVID-19 Outbreak Period related to the NE will end on July 10, 2023, since the OP ends 60 days after the NE ends. Employers and plan sponsors are rightly concerned with how to prepare for unwinding the changes that have had huge impacts on their group health plan administration (e.g., COBRA and HIPAA deadlines) and coverage (e.g., telehealth eligibility, COVID-19 testing and vaccination without cost sharing).
Next steps for plan sponsors will include participant notifications, coverage decisions, and coordination with vendors. We are regularly monitoring agency updates and vendor communications for clarity, and we are actively assisting our clients with these issues. We expect further guidance from the agencies to be issued over the next few weeks, and once issued we will provide detailed advice on next steps. We are also actively working with COBRA vendors and carriers/TPAs to understand how they intend to adopt the necessary measures to comply with and administer the new changes. To better understand the items to be aware of as the emergencies end, we suggest a review of the Update we issued last month which provided a detailed overview of the impact on health plan coverage rules and OP deadline extensions. Specifically, we suggest a review of our recent Update for a detailed overview of the following:
Public Health Emergency (PHE)
Another related issue that we are monitoring is when the federal government will stop paying for COVID-19 vaccines and therapeutics, at which point the commercial market will be responsible for purchasing these drugs. The Biden administration has indicated that this move to commercialization will occur this year and this change is likely to raise important issues for plan sponsors and plan participants alike, including with regard to cost and access. Since employers are expected to play an important role in this commercialization process, we are hopeful that employer group health plans will be given sufficient time to operationalize any related changes.
National Emergency (NE)
Due to the number and complexity of COVID-related rules that will change in some way at the end of the PHE and NE, we are hopeful the agencies will focus on compliance assistance and recognize the good faith efforts made by plan sponsors. We are aware that there are key questions to be addressed in light of the termination of the PHE and NE and there are several questions still to be addressed by the regulators on whether and how certain provisions will continue to apply.
We do expect that the agencies will issue more guidance prior to May 11th, and we are tracking responses received from various carriers and TPAs as to their next steps in response to the end of the emergencies. Once guidance is issued, we will be advising our clients as to how best to communicate the new health plan coverage rules and revised deadlines for elections, payments, and losses of coverage.
Conner Strong & Buckelew will provide updates and additional guidance as new information becomes available. Please contact your Conner Strong & Buckelew account representative toll-free at 1-877-861-3220 with any questions. For a complete list of Legislative Updates issued by Conner Strong & Buckelew, visit our online Resource Center.
