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The end of the COVID-19 public health emergency: What does this mean for health plans?

February 10, 2023 Article 6 min read
Scott McLellan Jonathon Trionfi
On January 30, the Biden administration announced its plan to end the public health emergency on May 11. Our benefit plan experts discuss how this impacts employer-sponsored health plans and the implications of fewer requirements for COVID-19-related health coverage rules.
U.S. flag flying in front of Capitol building.Since the U.S. Department of Health and Human Services (HHS) declared a public health emergency (PHE) on Jan. 31, 2020, COVID-19 testing, vaccines, and treatment have been provided at no cost, regardless of insurance status. However, on Jan. 30, 2023, the Biden administration announced the PHE will end on May 11, 2023. As a result, health plans will no longer be required to provide certain health plan coverage rules offered during the PHE, including:
  • COVID-19 tests, including at-home tests, without cost sharing for plan subscribers.
  • COVID-19 vaccines provided by out-of-network providers; however, plan subscribers will still receive vaccinations without paying out-of-pocket.
  • Stand-alone telehealth benefits for employees who aren’t eligible for coverage under any other group health plan offered by the employer.

The announcement also affects deadlines related to employer-sponsored group health plans extended during the pandemic, including extensions for requesting HIPAA special enrollment, electing COBRA coverage, and filing benefit claims and appeals.

For more information on how these changes will impact coverage rules for employer-sponsored health plans, download our bulletin. If you have questions about your particular health plan, please contact Plante Moran Group Benefit Advisors.

This Compliance Bulletin is not intended to be exhaustive nor should any discussion or opinions be construed as legal advice. Readers should contact legal counsel for legal advice. ©2023 Zywave, Inc. All rights reserved.

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