COBRA, HIPAA, and Claim Deadline Extensions are Optional for State and Local Governmental Group Health Plans
Non-federal governmental group health plans, such as state and local group health plans (including group health plans sponsored by public schools and colleges), are encouraged—but not required—to comply with recently announced deadline extensions applicable to group health plans subject to ERISA. On April 29, 2020, the Department of Labor (“DOL”), Department of Treasury (“Treasury”), and the IRS issued guidance requiring extensions of certain deadlines applicable to employer-sponsored group health plans (such as deadlines under COBRA, HIPAA and ERISA). See our previous client alert regarding this DOL, Treasury, and IRS guidance here.
On May 14, 2020, the Centers for Medicare & Medicaid Services (“CMS”) issued a bulletin announcing temporary relaxed enforcement of these deadlines consistent with the guidance issued by the DOL, Treasury, and IRS. While the CMS bulletin encourages plan sponsors of governmental group health plans to extend these deadlines, the extensions are not required.
Similar to the DOL, Treasury, and IRS guidance, the CMS bulletin designates the period from March 1, 2020 until the date that is 60 days after the President’s national emergency declaration for COVID-19 expires as the “outbreak period” for purposes of the various deadline extensions. Governmental group health plans may disregard the outbreak period for plan participants, beneficiaries, qualified beneficiaries, or claimants in determining the various deadlines.
Unlike the deadline extensions provided for group health plans subject to ERISA, the deadline extensions for governmental group health plans are optional. This provides governmental entities with flexibility to determine whether to extend deadlines and, if so, which deadlines will voluntarily be extended. Some governmental entities may choose not to extend any of these deadlines due to administrative challenges that may arise from allowing participants and beneficiaries a significantly longer time to request enrollment following a HIPAA special enrollment event, provide the required COBRA notifications, pay COBRA premiums, or submit benefit claims and appeals. Governmental entities that do voluntarily extend some or all of these deadlines should confirm that its carrier (if fully insured) or stop-loss carrier (if self-funded) will honor these extensions, especially since these deadline extensions are optional.
Similar to the DOL, Treasury, and IRS, CMS will continue to monitor the effects of the COVID-19 pandemic and may provide additional relief in the future. To the extent that there are different outbreak period end dates for different parts of the country, the relief in the CMS bulletin will apply in a manner consistent with the DOL, Treasury and IRS guidance.
CMS encourages plan sponsors of governmental group health plans to offer participants and beneficiaries deadline extensions similar to the DOL, Treasury, and IRS guidance. However, the bottom line is that these deadline extensions are optional for governmental group health plans.
If you have any questions, please contact one of the Miller Johnson employee benefits attorneys listed to the left.