Important Notice: Extension of Timelines in Response to COVID-19June 24, 2020
Today, our fully-insured and ERISA self-funded groups received the following email:
“As the public health response to COVID-19, the illness caused by the novel coronavirus, continues to evolve, we continue to seek ways to help you and your employees during these difficult times.
As you’re aware, under normal circumstances both you and your employees are required to meet specific timelines for many actions. As part of an effort to minimize the possibility of individuals losing benefits due to a failure to meet these specific timelines, and in compliance and partnership with recent federal requirements and related guidance, our fully-insured policies and the self-funded ERISA plans we administer are required to grant an extension period for the following timelines:
- The 30-day (or 60-day) period to request special enrollment under ERISA section 701(f) and Code section 9801(f).
- The date within which an individual may file a benefit claim.
- The date within which an individual may appeal an adverse benefit determination.
- The date within which an individual may file information to perfect a request for external review.
- The 60-day election period for COBRA continuation coverage.
- The date for making COBRA premium payments.
- The date for an individual to notify their plan of a qualifying event or determination of disability.
- The timeline for employers to determine the date for providing a COBRA election notice.
Please note that this relief is temporary. The extension period is determined by disregarding the “Outbreak Period” of the pandemic, which is defined as the period beginning March 1, 2020 and lasting until 60 days after the end of the National Emergency (or another date as may be announced by the federal government).
Put in simpler terms, the “Outbreak Period” will be disregarded when administering the above timelines and due dates. For example, if an action requires a 30-day timeline under normal circumstances, the plan will still require the 30-day timeline to be met, but the days between March 1, 2020 and 60 days after the end of the National Emergency (or another date as may be announced by the federal government) will not be counted toward those 30 days. Periods for event dates that fall prior to March 1, 2020 that have not yet been exhausted do count toward the maximum period to take action. Example: the event occurs on February 15, 2020 and under normal plan terms requires a 30-day reporting period. The period between February 16th and February 29, 2020 (14 days) is subtracted from the original 30 days, so the reporting must be completed within 16 days (30 – 14 = 16) of the end of the “Outbreak Period.” Please contact your client consultant if you need more information or require further clarity.
This guidance was issued by federal regulators on May 4, 2020. Please see this link for more information.
We encourage ERISA self-funded plans to post this notice on their website and make it available to their plan participants.
Please note that non-ERISA plans are not required, but are being encouraged by the Department of Health and Human Services, to follow these same guidelines. Client consultants will be reaching out to plan sponsors of non-ERISA plans to discuss.
As before, we invite you to visit our COVID-19 webpage for up-to-date information about the illness, our response and questions about coverage. We’re here to help you and your employees understand the requirements and related guidance that public health officials are providing, and to answer all questions about your plan’s coverage during this ongoing situation. As always, you can reach us by calling Client Support at (217) 902-8151 or emailing ClientSupport@healthalliance.org.
Health Alliance and Health Alliance Northwest”
If you have any questions, please contact Broker Services at BrokerServices@healthalliance.org or by calling (877) 917-8489.