Q. Several carriers are making changes related to the end of the COVID-19 Public Health Emergency as of May 11; however, I’ve seen guidance that states that the outbreak period doesn’t end until 60 days after that date, so changes wouldn’t need to be made until July. I’ve also seen guidance that, while the changes occur in May and July, plans don’t need to notify participants until September (though I’m not sure if that is correct if SMMs need to be sent for material reductions 60 days prior to the change). Can you clarify?
A. Following the end of the Public Health Emergency on May 11, plans and insurance companies can impose cost-sharing and other medical management requirements on COVID-19 tests, although the Departments of Labor, Treasury, and Health and Human Services encourage plans not to do so. Plans and insurers are encouraged to notify plan participants of the changes, but SBCs need not be amended mid-year. The July 11 date is important for the end of the extended periods people have to file claims under ERISA or COBRA. The Departments have issued an FAQ that includes more details. Kutak Rock has also published a Client Alert that may be helpful.
Responses to compliance questions provided by Kutak Rock.