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COMPLIANCE UPDATE: Implications of Ending the National COVID-19 Emergency for Group Health Plans

COMPLIANCE UPDATE: Implications of Ending the National COVID-19 Emergency for Group Health Plans

Currently, there is a lot of chatter and ‘what if scenarios’ circulating throughout the national news cycles about the end of the national emergency and public health emergency declarations. This has created a desire for clarity from employers seeking to better understand what this will means for them directly. 

Below we have assembled a summary snapshot to provide some simplification and clarity on what is known at this time. Keep in mind that this overview is not intended to be an exhaustive list of all COVID legislation, and is subject to change depending on congressional or presidential action. 


What We Know

On January 30, 2023, the Biden Administration announced its intent to end the following COVID-19 pandemic-related emergency declarations by May 11, 2023. Currently, H.R. 382 and H.J. Res 7 are before Congress, calling for an immediate end to the respective emergencies. However, President Biden has stated that he plans to extend the emergency declarations to May 11th, and then end both emergencies simultaneously.

  • COVID-19 National Emergency Declaration
  • Public Health Emergency (PHE) Declaration

The following legislative efforts are tied to one or more of these emergency declarations and, therefore, are scheduled to also expire when the emergency period ends (or by the expiration of a specified timeframe after). 

  • Families First Coronavirus Response Act (FFCRA)
  • Coronavirus Aid, Relief, and Economic Security Act (CARES)
  • American Rescue Plan Act (ARPA)
  • Inflation Reduction Act (IRA)
  • Consolidated Appropriations Act (CAA)


Impact on Group Health Plans

  • During both the Public Health Emergency (PHE) and the Outbreak Period (OP) related to the COVID-19 National Emergency, group health plans have been subject to various departmental guidance that has mandated particular coverage or relaxed or modified certain generally applicable rules governing health plan administration. 
  • All of those modified rules will expire either on May 11, 2023, or July 10, 2023, and group health plans will need to be prepared.
    • Specifically, PHE guidance dictated that group health plans must pay for certain COVID-19 tests and related services at no cost. When the PHE ends, plans must decide how they will cover such items and related costs. Whatever choices plan sponsors make, they will need to:
      • Modify all plan documentation and descriptive materials to accurately reflect how these items and services will be treated
      • May need to prepare a 60-day notice of reduction in plan benefits
      • Non-grandfathered plans will still be required to cover COVID-19 vaccines but can limit no-cost coverage to in-network providers
  • The OP runs until 60 days after the end of the national emergency. Assuming the President declares an end to the national emergency effective May 11, 2023, the OP will end 60 days later, or July 10, 2023. The OP end date will start the clock running on various compliance dates and deadlines that have been relaxed during the OP. All of these extensions and tolling of deadlines will revert to pre-OP rules on July 10, 2023. This will impact specifically, 
    • Guidance issued for purposes of 
      • HIPAA special enrollment periods, 
      • COBRA election and premium payment periods,
      • Participant notice periods relating to COBRA qualifying events 
      • Social Security Administration disability determinations
    • Guidance gave participants more time to 
      • file claims and seek appeals of claims denials
      • more time to issue certain notices like COBRA election notice


How To Prepare

  • Stay alert for final decisions and announcements by Congress and the Biden Administration 
  • Review all forms, notices, and related communications regarding deadlines, claims, appeals, and notice requirements.
  • Modify these materials as needed to remove references to the COVID-19 guidance, extended deadlines, and other information, that will expire when the PHE and OP end.