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Benefits Buzz - May 2023

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End of COVID-19 National Emergency Impacts Health Plan Deadlines    

On April 10, President Joe Biden signed a resolution ending the COVID-19 national emergency. The national emergency was originally scheduled to end May 11, when the COVID-19 public health emergency ends.

Various employee benefit plan deadlines have been extended during an “outbreak period.” The outbreak period continues until 60 days after the end of the national emergency (or such other date as announced by the federal government).

Deadline extensions that apply during the outbreak period include:

  • HIPAA special enrollment — The 30-day period (or 60-day period, if applicable) to request special enrollment.
  • Claims and appeals — The deadline to file a benefits claim, file an appeal of an adverse benefit determination or request an external review under the plan’s claims and appeals procedures.
  • COBRA notices and premiums — The period for qualified beneficiaries to elect COBRA coverage and make COBRA premium payments, and the date for individuals to notify the plan of a qualifying event or disability determination.

In a set of frequently asked questions from March 29, federal agencies announced that the outbreak period will end July 10 (60 days after May 11). Federal agencies have not adjusted this date for the early end of the national emergency.

Once the outbreak period ends, health plans return to their nonextended deadlines. When the PHE ends, health plans will no longer be required to cover COVID-19 diagnostic tests and related services without cost sharing. Health plans will still be required to cover recommended preventive services, including COVID-19 immunizations, without cost sharing, but this coverage requirement will be limited to in-network providers.

Prescription Drug Report Due by June 1

The deadline for health plans and health insurance issuers to submit their second prescription drug data collection (RxDC) report is June 1.

RxDC reports must be submitted through an online portal maintained by the Centers for Medicare and Medicaid Services. The agency’s RxDC website provides updated reporting instructions and other reporting resources. The first RxDC report was due by Dec. 27, 2022 (covering data for 2020 and 2021); however, federal agencies provided a submission grace period through Jan. 31, 2023. The second RxDC report is due by June 1, 2023, and must include data for 2022.

Health plans may use a third party — such as an issuer, third-party administrator or pharmacy benefit manager — to prepare and submit the RxDC report on their behalf.

To do this, a plan must enter into a written agreement with the third party to address this reporting responsibility. Health plans are allowed to submit RxDC reports on their own, but most employers will likely rely on third parties to prepare and submit the reports.

For more information about employee benefits, our services and products, contact HANYS Benefit Services by email or call 800.388.1963.

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