On April 29, 2020, in response to the COVID-19 pandemic, the Department of Labor and the Treasury (the Departments) issued the “Final Rule,” which extended deadlines to elect COBRA, pay COBRA premiums, elect HIPAA special enrollments, and file benefit claims, appeals, and external review requests during the “Outbreak Period.” MedBen clients have already received plan amendments that reflect these requirements.According to the Final Rule, the Outbreak Period began on March 1, 2020, and ends 60 days after “the announced end of the National Emergency or other date announced by the Departments in a future notification.” Please bear in mind that the National Emergency is different than the public health emergency placed by Health and Human Services that applies to other Covid-19 related services, such as covering Covid-19 testing with no cost-sharing.
So, when will the Outbreak Period end? Additional guidance was finally made available by the Departments at the end of February 2021, with the release of Disaster Relief Notice 2021-01 (“Notice”). The Notice states that the outbreak period will be measured on an individual or case by case basis. Specifically, it will end the earlier of:
- 1 year from the date the deadline would have begun running for that individual; or
- 60 days from the end of the National Emergency (the end of the Outbreak Period), which is still in effect at this time.
However, in no case will the maximum disregarded period exceed 1 year.
Below are two examples to help illustrate how the Outbreak Extension Periods are now to be calculated.
If a plan member was 15 days into their COBRA election period on March 1, 2020, the Notice requires that the remainder of their election period be delayed until February 28, 2021 (which is the earlier of 1 year from the original election date or the end of the outbreak period). The member would then be entitled to the remainder of their COBRA election period (45 days).
If a plan member began their COBRA election period on April 1, 2020, the Notice requires that the election period be delayed until March 1, 2021 (which is the earlier of 1 year from the original election date or the end of the outbreak period). The member would then be entitled to the 60 day election period.
If a plan member would have been required to make a COBRA election on March 1, 2021, the Notice requires that the election period be delayed until the earlier of 1 year from the original at date (March 1, 2022) or the end of the outbreak period (whichever occurs first). The member would then be entitled to the 60 day election period.
Example #2 – Special Enrollment Event Election
If a plan member was 15 days into their special enrollment event election period on March 1, 2020, the Notice requires that the remainder of their election period be delayed until February 28, 2021 (which is the earlier of 1 year from the original election date or the end of the outbreak period). The member would then be entitled to the remainder of their Special Enrollment Event election period (16 days).
If a plan member would have been eligible for a special enrollment event and had to make such an election by March 1, 2021, the Notice delays the 31 day special enrollment election opportunity until the earlier of 1 year from the original date (March 1, 2022) or the end of the outbreak period (whichever occurs first). The member would then be entitled to the remainder of their Special Enrollment Event election period (16 days).
As always, MedBen will keep you updated on this issue – including letting you know what the Departments do.
These rules can be confusing. If you have any questions, please contact your Account Management Team or MedBen’s Compliance Department for answers.