While mask mandates have ended in all US states, it is easy to fall into old habits and start living in pre-pandemic ways. But, employers cannot do that just yet when it comes to administering their benefits plans. President Biden announced the continuation of the COVID-19 national emergency beyond March 1st in February which means that the DOL extensions of time issued in 2020 and clarified in 2021 are still in force. The DOL’s relief extends participant deadlines under HIPAA special enrollment events, COBRA election and payment timeframes, and ERISA claim deadlines until the earlier of:
- One year from the date an individual is first eligible for relief; or
- 60 days after the end of the COVID-19 national emergency.
Many employers use COBRA administrators and claims administrators that help administer extensions of time under COBRA and ERISA, but most employers administer their own participant eligibility and enrollment changes. Consequently, employers may be apt to forget that participant deadlines applicable to HIPAA special enrollment periods give participants more time to make a request for enrollment.
Standard Special Enrollment Period
Under normal circumstances, HIPAA special enrollment events provide participants 30 days to make a request for enrollment when a participant experiences a special enrollment event such as:
- Loss of eligibility for health plan coverage, or
- Acquisition of a new dependent by marriage, birth, adoption or placement for adoption.
When a participant experiences a HIPAA special enrollment event, an employer must allow the participant to enroll or change their enrollment and provide coverage no later than the first of the month following the date of the request. The DOL’s emergency relief outlined above extends the normal deadlines to give plan participants additional time to request enrollment in such instances.
Impact of Extension of Time
Let’s assume that an employee, Devyn, adopts a child during the national emergency on September 15, 2021, but does not request enrollment until May 1, 2022. Can Devyn and the child enroll in the group health plan now? I know it may seem like like the answer is "no", but they can enroll. Remember, participants have 30 days plus the earlier of one year from the date the individual was first eligible for relief or 60 days after the end of the national emergency or “outbreak period” to request enrollment.
Let’s look at another employee, Joel who got married on March 10, 2022. We will assume that the end of the national emergency is announced on May 1, 2022. Joel has until July 30, 2022 to enroll his new wife. This is because Joel has 60 days after the announced end of the national emergency also know as the Outbreak Period plus the standard 30 day special enrollment period to request a change in enrollment.
These extensions of time apply even if the reason the participant is delayed in their request is unrelated to the national emergency and COVID-19.
Please reach out to your HORAN representative with additional questions at 800.544.8306.
The information contained in this document is informational only and is not intended as, nor should it be construed as, legal or accounting advice. Neither HORAN nor its consultants provide legal, tax nor accounting advice of any kind. We make no legal representation, nor do we take legal responsibility of any kind regarding regulatory compliance. Please consult your counsel for a definitive interpretation of current statute and regulation and their impact on you and your organization.