Telehealth Coverage for HDHP’s Extended
The Consolidated Appropriations Act, 2022 (“CAA 2022”) was signed into law this month. A part of this spending bill temporarily extends the ability of high-deductible health plans (HDHPs) to provide benefits for telehealth or other remote care services before the deductible has been met without risking health savings account (HSA) eligibility.
Under the extension, HDHPs may choose to waive the deductible for any telehealth services from April 2022 through the end of 2022 without causing participants to lose HSA eligibility. This provision is optional; therefore, HDHPs can continue to choose to apply any telehealth services toward the deductible.
It is important to note that telemedicine services provided between January 1, 2022 and April 1, 2022, must still be counted toward the HDHP deductible to avoid impacting participants’ eligibility for HSA contributions.
Potential Employer Action Items
In determining whether to allow this flexibility, employers should consider the following:
- Employers will need to communicate all changes clearly to their employees as the relief provided can be confusing (e.g. for some plans, including calendar year plans, the relief will not apply for the months of January – March, and thus, those plans will still need to apply their minimum deductible to telehealth and other remote care services).
- Plan documents will need to be updated to explain adopted changes (if applicable).
- For fully-insured plans, employers should confirm whether their insurer will be permitting this relief.
- For self-insured plans, employers should check with their third-party administrator to see if their systems are able to accommodate these changes
COVID-19 National Emergency Extended, Certain Deadlines Extended
The National Emergency related to the COVID-19 pandemic, which was originally declared in March 2020, was extended by President Biden. In sum, the extension states it will be in effect beyond the deadline of March 1, 2022. This extension is relevant to certain employee benefit plan deadlines. Specifically:
- HIPAA time frames—The 30-day period (or 60-day period, if applicable) to request special enrollment.
- COBRA time frames—The 60-day period to elect COBRA coverage; the date for making COBRA premium payments (generally at least 45 days after the day of the initial COBRA election, with a grace period of at least 30 days for subsequent premium payments); and the date for individuals to notify the plan of a qualifying event or disability determination (generally 60 days from the date of the event, loss of coverage or disability determination).
- Claims procedures time frames—The date within which individuals may file a benefit claim under the plan’s claims procedure, and the date within which claimants may file an appeal of an adverse benefit determination under the plan’s claims procedure.
- External review process time frames—The date within which claimants may file a request for an external review after receipt of an adverse benefit determination or final internal adverse benefit determination, and the date within which a claimant may file information to perfect a request for external review upon a finding that the request was not complete.
These deadlines can continue to be disregarded until the earlier of one year from the date individuals were first eligible for relief or 60 days after the announced end of the National Emergency (referred to as the “Outbreak Period”).