Important Notice about Extended Deadlines for 1) COBRA, 2) Special Enrollment, and 3) Healthcare Claim Filings and Appeals
The Federal government has extended certain deadlines for both group health plans and their plan members due to the current pandemic. These extensions were in response to President Donald Trump declaring a national emergency with respect to the coronavirus (COVID-19) outbreak (“National Emergency”). The government has stated that the period starting March 1, 2020 and ending 60 days after the announced end of the National Emergency is the "Outbreak Period." (The government has not yet identified the end date of the National Emergency, and thus the end date of the Outbreak Period currently remains unknown.) Consequently, (i) any of the following time periods that began before March 1, 2020 but did not expire prior to March 1 are suspended until the end of the Outbreak Period, and (ii) the start date of any of the following time periods that would otherwise begin on or after March 1 is also postponed until the end of the Outbreak Period for all group health plans subject to ERISA or the Internal Revenue Code:
HIPAA Special Enrollment. The 30 and 60 day HIPAA special enrollment periods are extended until the Outbreak Period ends.
COBRA. Multiple COBRA deadlines have been extended until the Outbreak Period ends, including (1) the deadline to notify the plan of a qualifying event; (2) the 60 day deadline for individuals to notify the plan of a determination of disability; (3) the 14 day deadline for plan administrators to furnish COBRA election notices; (4) the 60 day deadline for participants to elect COBRA; and (5) the 45 day deadline in which to make a first premium payment and 30 day deadline for subsequent premium payments.
Claims Procedures. The deadlines are extended until the Outbreak Period ends for plan members 1) to file claims for benefits, and 2) to appeal adverse benefit determinations. (Group health plans must normally allow at least 180 days in which to appeal.)
External Review Process. Non-grandfathered group health plan deadlines have been extended until the Outbreak Period ends with respect to requests for external review. (Group health plans must allow four months after the receipt of a notice of a final adverse benefit determination in which to request an external review.) Other deadlines that apply for perfecting an incomplete request for review are also extended until the Outbreak Period ends.