Regulators Extend Time Frames for Special and COBRA Health Plan Enrollment

The Department of Labor (DOL) in conjunction with the Treasury Department and the IRS has published a joint notice to announce an extension for several deadlines so plan participants, beneficiaries and employers have additional time to make critical health coverage and other decisions affecting benefits during the COVID-19 outbreak.

For group health plans, subject to the Employee Retirement Income Security Act (ERISA) or the Internal Revenue Code, the relief provides additional time to comply with certain deadlines affecting Consolidated Omnibus Budget Reconciliation Act (COBRA) continuation coverage, special enrollment periods, claims for benefits, appeals of denied claims and external review of certain claims. Regarding disability, retirement and other plans, the joint notice provides additional time for participants and beneficiaries to make claims for benefits and appeal denied claims.

All group health plans, disability and other employee welfare benefit plans, and employee pension benefit plans subject to ERISA or the Internal Revenue Code must disregard the period from March 1 until 60 days after the announced end of the national emergency or such other date announced by the agencies in a future notice—what the regulators call the “Outbreak Period”—for all plan participants, beneficiaries, qualified beneficiaries or claimants wherever located in determining:

• The 30-day period (or 60-day period, if applicable) to request special enrollment;
• The 60-day election period for COBRA continuation coverage;
• The date for making COBRA premium payments;
• The date for individuals to notify the plan of a qualifying event or determination of disability;
• The date within which individuals may file a benefit claim under the plan’s claims procedure; and
• The dates within which claimants may file an appeal of benefits determinations or external reviews.

With respect to group health plans and their sponsors and administrators, the Outbreak Period shall be disregarded when determining the date for providing a COBRA election notice.

The notice offers seven examples to illustrate the time frame for extensions assuming an end date for the national emergency of April 30, with the outbreak period ending on June 29, which is the 60th day after the end of the national emergency.

The first example: Individual A works for Employer X and participates in X’s group health plan. Due to the national emergency, Individual A experiences a qualifying event for COBRA purposes as a result of a reduction of hours below the hours necessary to meet the group health plan’s eligibility requirements and has no other coverage. Individual A is provided a COBRA election notice on April 1. He is eligible to elect COBRA coverage under Employer X’s plan. The Outbreak Period is disregarded for purposes of determining Individual A’s COBRA election period. The last day of his COBRA election period is 60 days after June 29, which is August 28.

The agencies say they will continue to monitor the effects of the outbreak and may provide additional relief as warranted.