Views:

What is the temporary relief? 

As part of the IRS/DOL response to COVID-19, multiple COBRA and health plan deadlines were extended to the earlier of the following: 

  • 60 days after the end of the national emergency (the Outbreak Period)
  • One year after the initial deadline for any given individual

  

Which deadlines are affected by this relief?

Following are the deadlines that remain impacted by this legislation and for which the new deadline extension framework applies.

 

COBRA

  • The 60-day deadline for individuals to notify the plan of a qualifying event
  • The 60-day deadline for individuals to notify the plan of a SS determination of disability
  • The 30-day deadline for employers to notify plan administrators of a COBRA event
  • The 14-day deadline for plan administrators to furnish COBRA election notices (44 days when combined with 30 days above)
  • The 60-day deadline for participants to elect COBRA
  • The 45-day deadline in which to make a first premium payment
  • The 30-day deadline for subsequent premium payments.

 

HIPAA Special Enrollment (aka Qualifying Life Events)

  • The 30-day special enrollment period triggered when eligible employees or dependents lose eligibility for other health plan coverage (in which they were previously enrolled)
  • The 30-day special enrollment period triggered when an eligible employee acquires a dependent through birth, marriage, adoption, or placement for adoption
  • The 60-day special enrollment period triggered by changes in eligibility for state premium assistance under the Children’s Health Insurance Program or loss of Medicaid/CHIP eligibility.

 

Group Health Plans (Including FSAs)

  • The deadline for individuals to file claims for benefits, for initial disposition of claims, and for providing claimants a reasonable opportunity to appeal adverse benefit determinations
  • The 180-day timeframe to appeal

 

Examples

Example #1: A qualified beneficiary would have been required to make a COBRA election by March 1, 2020. The new guidance delays that requirement until February 28, 2021. This is the earlier of one year from March 1, 2020 or the end of the Outbreak Period (which remains ongoing).

 

Example #2: A qualified beneficiary would have been required to make a COBRA election by March 1, 2021. The new guidance delays that election requirement until the earlier of one year from that date (i.e., March 1, 2022) or the end of the Outbreak Period.

In all circumstances, the delay for actions required or permitted does not exceed one year.

 

Commentary

Although the deadline extensions represent welcome relief and flexibility, employees and qualified beneficiaries are strongly encouraged to avoid administrative issues and processing delays by making election changes, appeals, payments, etc. as soon as possible.