Author: Shelly Hodges-Konys, Director of Compliance
Groundhog Day or “Same story. Different day.” come to mind when considering the most recent legislative change contained in the Consolidated Appropriations Act (CAA), 2022, signed by President Biden on March 15th. This is because the act provides the same telehealth relief afforded to high deductible health plans through the CARES act – meaning that a high deductible health plan (HDHP) may waive participant cost-sharing for all telehealth services without jeopardizing an individual’s eligibility to make health savings account contributions. But, there are a couple of wrinkles that employer plan sponsors should understand.
Relief is Temporary
The first is that the relief contained in the current CAA spending bill is temporary. The relief only allows telehealth coverage to be covered at 100% prior to the deductible being met and regardless of diagnosis for HDHPs through the end of 2022. Just like the relief extended under the CARES act ended as of December 31, 2021, this relief will end as of the 2022 calendar year too.
There is a Gap between the Periods of Relief
This new extended relief for HDHPs does not begin until April 1st, 2022. The prior relief under the CARES act ended as of December 31, 2021. This creates a three-month gap in the relief. This means that if a HDHP provided telehealth services at 100%, for non-preventive care, prior to the deductible being met between January and March of this year, a participant’s health savings account contributions could be disqualified.
This Relief is Discretionary
It is up to insurers and employer plan sponsors whether or not they wish to make this relief available through their HDHP plans. Providing telehealth services free of charge prior to the deductible through an HDHP is not required. A large majority of health plans and employer plan sponsors provided this relief initially in 2020 and it is assumed that they may afford the relief again, but this may not be the case in all circumstances. Employers will need to amend their plans to provide the relief and or discontinue the relief if it is not extended again.
Employers should understand that the vendor market was caught off guard by this relief. Because the relief is temporary and only available for a portion of the year, some health plan vendors and insurers may choose not to provide it as part of their plans or service offerings. HORAN is working with its vendor partners to understand the options available to both fully-insured and self-funded employer plan sponsors. As a first step, employers should contemplate whether they wish to offer the relief to its plan participants if it is an available option.
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.