Summary

• Employers have the option of amending cafeteria plans to permit prospective mid-year group health plan enrollment changes such as new enrollment, change in plan option, or declining coverage
• To prospectively decline coverage, employees must attest in writing that they plan to enroll in other comprehensive health coverage. Sample attestation language is available.
• More details available in IRS Notice 2020-29

Next Steps

• Decide whether group health plan(s) should allow these enrollment changes (or some portion of them)
• Work with TPAs/carriers to implement enrollment changes, if any
• Communicate plan changes to eligible employees
• Amend cafeteria and other plan documents accordingly by 12/31/2021

1/1/2020 – 12/31/2020

Summary

• The usual 30-day deadline for employees to request group health plan enrollment after a special enrollment event (birth, marriage, loss of coverage, etc.) is suspended
• Details available in guidance

Next Steps

• Evaluate current special enrollment procedures to determine what changes are needed
• Work with TPAs/vendors to implement special enrollment changes (including retroactive enrollments), as needed
• Communicate changes to employees, as needed
• Document changes to special enrollment procedures

Emergency ends (2/28/2021 at latest)

Summary

• Employers have the option of amending cafeteria plans to permit prospective mid-year health FSA election changes such as new election, increase/decrease in contribution amount, or declining coverage
• Employers can limit mid-year election changes so that health FSA balances cover amounts already reimbursed
• For grace periods or plan years ending in 2020, employers have the option of allowing unused health FSA balances to reimburse expenses incurred through 12/31/2020
• Employers have the option of increasing the maximum health FSA carryover to 20% of the maximum salary reduction contribution ($550 for 2020)
• More details available in IRS Notice 2020-29 and IRS Notice 2020-33

Next Steps

• Decide whether health FSAs should allow these enrollment, claims period, and carryover changes (or some portion of them)
• Work with TPAs/vendors to implement enrollment changes, if any
• Communicate plan changes to eligible employees
• Amend cafeteria and other plan documents accordingly by 12/31/2021

1/1/2020 – 12/31/2020

Note: Health FSA carryover increase is permanent and will update every year

Summary

• Employers have the option of amending cafeteria plans to permit prospective mid-year DCAP election changes such as new election, increase/decrease in contribution amount, or declining coverage
• For grace periods or plan years ending in 2020, employers can allow unused DCAP balances to reimburse expenses incurred through 12/31/2020
• More details available in IRS Notice 2020-29

Next Steps

• Decide whether DCAPs should allow these enrollment and claims period changes (or some portion of them)
• Work with TPAs/vendors to implement enrollment changes, if any
• Communicate plan changes to eligible employees
• Amend cafeteria and other plan documents accordingly by 12/31/2021

1/1/2020 – 12/31/2020

Summary

• The usual 60-day deadline for employees to notify employers of COBRA qualifying events (divorce, end of dependent status, disability, etc.) is suspended
• The usual 14-day deadline for employers to send COBRA election notices is suspended
• The usual 60-day deadline for employees to elect COBRA is suspended
• 45 and 30-day deadlines for employees to pay COBRA premiums are suspended
• Details available in guidance

Next Steps

• Evaluate current COBRA procedures to determine what changes are needed
• Work with TPAs/vendors to implement changes, including retroactive enrollments and new premium collection procedures, as needed
• Communicate COBRA changes to employees, as needed
• Document changes to COBRA procedures

3/1/2020 – 60 days after COVID-19 National Emergency ends (2/28/2021 at latest)

Summary

• The usual plan deadlines for filing claims are suspended
• The usual 60-day deadline for employees to file other welfare claims is suspended
• The usual 4-month deadline for employees to file requests for external review is suspended
• Details available in guidance

Next Steps

• Evaluate current claims/external review procedures to determine what changes are needed
• The usual 180-day deadline for employees to file health claim appeals (including medical, health FSA, and HRA claims) is suspended
• Work with TPAs/independent review organizations/vendors to implement changes, including review of past claim/appeal denials, as needed
• Communicate procedure changes to employees, as needed
• Document changes to claims/external review procedures

3/1/2020 – 60 days after COVID-19 National Emergency ends (2/28/2021 at latest)

Summary

• SPDs, SMMs, claim extensions, claims denials, responses to requests for plan documents (and other ERISA-required notices) can be provided “as soon as administratively practicable under the circumstances”
• Electronic delivery allowed (email, text, website) if employer reasonably believes participants have effective access
• Details available in EBSA Disaster Relief Notice 2020-01

Next Steps

• Evaluate current notice/disclosure procedures to determine if changes are desirable
• Work with TPAs/vendors to implement changes, if any
• Communicate plan changes to employees, as needed
• Document changes to notice/disclosure procedures

3/1/2020 – 60 days after COVID-19 National Emergency ends (2/28/2021 at latest)

COVID-19 Testing

Summary

• Families First Act requires all plans to cover COVID-19 testing with no cost-sharing; CARES Act provides additional details
• Please see this article for full details.

3/18/2020 – 6/16/2020 (unless extended)

Telehealth

Summary

• HSAs paired with HDHPs can (but are not required to) cover all telehealth and other remote care services before participants satisfy deductibles
• This safe harbor can apply retroactively to services provided 1/1/2020 and after (see IRS Notice 2020-29).

Next Steps

• Work with TPAs/carriers to determine how copays, deductibles, or other cost-sharing will apply to telehealth
• Amend plan documents and other disclosures, if needed
• Determine how to communicate plan changes, if any, to participants

1/1/2020 through plan years beginning on or before 12/31/2021

OTC Medications

Summary

• HSAs, HRAs, and health FSAs can (but are not required to) reimburse costs of over-the-counter drugs without a prescription

Next Steps

• Work with TPAs/carriers to determine if and how HSA/HRA/FSA reimbursement of OTC medications will work
• Amend plan documents and other disclosures, if needed
• Determine how to communicate plan changes, if any, to participants

Expenses incurred after 12/31/2019

Menstrual Care Products

Summary

• HSAs, HRAs, and health FSAs can (but are not required to) reimburse costs of menstrual care products without a prescription

Next Steps

• Work with TPAs/carriers to determine if and how HSA/HRA/FSA reimbursement of menstrual care products will work
• Amend plan documents and other disclosures, if needed
• Determine how to communicate plan changes, if any, to participants

Expenses incurred after 12/31/2019

Paid Leave

Summary

• Families First Act included Emergency Paid Sick Leave and Emergency Family and Medical Leave Expansion for employers with fewer than 500 employees
• CARES Act clarifies dollar limits for both types of leave and extends Emergency Family and Medical Leave Expansion to certain employees who were laid off and rehired
• Families First Act allows employers a refundable tax credit to offset costs of new leave requirements
• CARES Act provides for advance of payroll tax credit
• DOL guidance available
• IRS guidance available

Next Steps

• Work with payroll and legal departments to determine whether new FMLA, paid sick leave, and payroll tax credit provisions apply to any portion of your company
• Amend plan documents and other disclosures, if needed
• Determine how to communicate leave benefit changes, if any, to participants

4/1/2020 – 12/31/2020

Educational Assistance Programs

Summary

• Employers’ educational assistance programs can now include, on a tax-advantaged basis, payments toward employees’ student loans
• Total educational assistance program benefits remain capped at $5,250 per year

Next Steps

• Determine if educational assistance program should include student loan contributions
• Amend plan documents and other disclosures, if needed
• Determine how to communicate changes, if any, to employees

3/27/2020 – 12/31/2020

Future Vaccine Coverage

Summary

• CARES Act requires all plans to cover COVID-19 preventive services without cost-sharing
• Includes immunizations, items, or services recommended by USPSTF or ACIP

Next Steps

• Watch for USPSTF or ACIP updates
• Discuss future implementation with TPAs/carriers

15 business days after recommendation by USPSTF or ACIP