If a self-funded plan sponsor engages a telemedicine vendor that is separate from their qualified high deductible health plan, are they able to offer these services at no charge to members on the health insurance plan? The group pays a separate PEPM fee to the telemedicine vendor and telemedicine claims process outside of the group health plan. Would this be considered a first-dollar benefit and nullify the tax-free status of the QHDHP plan?
Whether the telehealth service is provided inside of or outside of the HDHP does not matter. Under normal times, you cannot offer a telehealth benefit with an HDHP and allow members to contribute to an HSA unless the telehealth benefit is not available until after the high deductible is met.
However, as part of the budget bill passed late last year, Congress extended the COVID-era relaxation of these rules. During the pandemic, Congress permitted telehealth in HDHPs, even if the employee did not meet the deductible. Congress has extended this relief for plan years beginning after December 31, 2022, but before January 1, 2025. This means an employer can allow no-deductible telehealth services, or telehealth services before the HDHP is satisfied, and still allow employees to contribute to an HSA for the next two years.