Federal agencies have issued a new rule providing relief from certain deadlines applicable to group health plans and other welfare benefits. This rule, which will be published as final on 5/4, applies to all plans covered by ERISA or the IRS Code. The news release with applicable links is available
The guidance applies immediately and retroactively, broadly extending various plan deadlines based on a defined “outbreak period.” The period begins 3/1/20 and ends 60 days after the announced end of the COVID-19 state of emergency. Under the new rule, the outbreak period is deemed by DOL/IRS to be disregarded (translation: deadlines paused) for the following purposes:
- COBRA. Deadlines extended through the outbreak period include: (1) deadline for plan to furnish COBRA election notice; (2) deadline for participant to elect COBRA; (3) deadline for qualified beneficiary to make a first premium payment or ongoing premium payment (deadline + grace period); (4) deadline for individual or employer to notify plan of a qualifying event; and (5) deadline for individual to notify the plan of a determination of disability.
- HIPAA Special Enrollment. Special enrollment periods extended include: (1) 30-day special enrollment period when employee or dependent loses eligibility for other health coverage in which they were enrolled, or when an eligible employee acquires a dependent through birth, marriage, or adoption; and (2) 60-day special enrollment period triggered by changes in eligibility for state premium assistance under CHIP.
- Claims Procedures & Distribution of Required Notices. Deadlines are extended for individuals to file claims for benefits, plans to adjudicate claims, participants to appeal denied claims, and completion of any required external review process. In addition, plans and fiduciaries will not be treated as violating ERISA if required notices or documents (that would otherwise be due during the outbreak period) are furnished “as soon as administratively practicable under the circumstances.”
What do we need to do now & how is ProBenefits adapting?
We are currently assessing the impact of these changes on support services we provide for your plans, including COBRA administration.
- There is nothing you need to do right now. The only immediate change is for individuals that are currently in an election window or premium payment deadline scenario. We will communicate soon how best to handle those scenarios and communicate with qualified beneficiaries.
- We will continue to send required notices based on standard deadlines and procedures.
- Regarding extension of participant deadlines, we are addressing our system capabilities and will share more details soon on necessary adjustments to adapt to these short-term changes.
- Importantly, many of the practical issues about handling coverage will depend on carrier practices. We and employers/advisors need to hear from the carriers before going too far with new approaches.
- In addition to more info soon, we will be hosting a webinar with information on this topic on Wednesday, May 13. You may register here anytime.
- There is nothing you need to do. The plan requires no formal changes. We will handle requests for election changes (for special enrollment or otherwise) according to current law.
- Regarding potential adjustments to claim deadlines – such as runout periods for FSAs and HRAs – we are assessing potential changes and will have more info soon.
Thank you for your engagement on these challenging but important topics. We will be in touch soon with more information. If you have any questions or would like more info on any topic, please contact us.
You can reach out to your Account Manager directly, or email us at
, or call us at 888.722.8382 – we’re here to help.