On April 28, 2020, the Departments of Labor and Treasury jointly announced regulatory changes due to the impact of the COVID-19 (Coronavirus) pandemic. These regulations are meant to provide relief for members and plan administrators and are effective retroactively to March 1, 2020. Below is additional detail regarding these changes and LBS’s response.
What are the regulatory changes?
The time frames within which members can submit claims for coverage, elect and pay for COBRA continuation coverage, enroll in group health plan coverage, and file appeals for adverse benefit determinations have been extended.
Who do the extensions apply to?
The extensions apply to employee benefit plans, employers, members, and beneficiaries subject to the Employee Retirement Income Security Act (ERISA).
Are the extensions retroactive and when do they end?
The extensions are retroactive to March 1, 2020 and ends 60 days after the COVID-19 National Emergency has been lifted. The federal government will decide when the National Emergency has ended.
How will LBS be handling the regulatory changes identified above?
LBS is working on an operational plan to automatically extend all applicable deadlines and abide by the new regulatory requirements.
Group health, disability, welfare benefit, and retirement plans subject to ERISA must “disregard the period from March 1 until 60 days after the announced end of the National Emergency or such other date as announced by the agencies.”
The time periods in which members can elect and pay for COBRA continuation coverage are tolled, or suspended, through the National Emergency.
Key Time Frames that have been tolled:
- 30 or 60-day deadline to notify a plan of a COBRA qualifying event
- 14-day deadline for providing COBRA election notices
- 60-day COBRA Election Period
- Initial 45-day premium payment due date
- Grace period for premium payment due date
- 60-day deadline for individuals to notify a plan of a disability
How will claims be impacted if a member has not paid the required premium for coverage?
Each respective insurance provider will have their own policy and procedure with respect to claims processing. A member cannot be denied coverage; however, the insurance provider is not obligated to pay for the service until the premium is satisfied. The member may be required to pay out of pocket and file for reimbursement, or the insurer may pay the claim and request reimbursement from the member or provider.
Reimbursement Account deadlines to file reimbursement claims for Flexible Spending Accounts and Health Reimbursement Accounts will be extended to 60 days after the COVID-19 National Emergency has been lifted.
Form 5500 filings that would otherwise be due on or after April 1 and before July 15, 2020, are now due on July 15, 2020.
For more detailed information, please visit the Department of Labor’s website or consult your own employee benefits counsel.
Please know that we will follow all regulations and guidance, but these changes will impact our internal operational processes and we are working to make the necessary changes.
As we work through our amended processes, we will post additional information on our website at www.lifetimebenefitsolutions.com/covid19.