Individuals can take advantage of extended deadlines to enroll in health insurance plans or elect and pay for COBRA insurance continuation coverage. These extensions are part of the government’s response to the national emergency caused by the Coronavirus COVID-19) pandemic.
The deadlines are effectively extended because plans must disregard the “Outbreak Period” when they calculate timeframes, such as enrollment periods and premium due dates. The outbreak period began on March 1, 2020, and it will end 60 days after the coronavirus national emergency ends.
Health Plan Enrollment Deadlines Extended
People can generally enroll in group health plans only during the annual enrollment period. However, group health plans must also allow special enrollment periods in certain circumstances, commonly known as “life events.” Common life events are things like an employee or dependent:
- losing health insurance coverage,
- having a child, or
- getting married.
The employee or dependent generally has 30 days after the life event to request enrollment. However, the running of this 30-day period is suspended during the Outbreak period plus 60 days.
Example. Mary is eligible for her employer-sponsored group health plan. On March 31, 2020, she gave birth and would like to enroll herself and the child into her employer’s plan; however, open enrollment does not begin until November 15. When can Mary exercise her special enrollment rights?
Answer. Mary’s special enrollment period begins on her child’s birthdate, and would normally end 30 days later. However, the Outbreak Period is disregarded in determining her special enrollment period. So, for instance, if the national emergency were to end on June 30, 2020, the Outbreak Period would end on August 29, 2020 (the 60 th day after the end of the national emergency). Mary would have through September 28, 2020 (30 days after August 29) to enroll herself and her child into her employer’s plan.
COBRA Timeframes Extended
- elect COBRA continuation coverage within 60 days after the loss of coverage, and
- pay the premium within 30 days after the first day of the period for which payment is being made.
COBRA Election Period Extended
Here’s how the extended timeframe works for electing COBRA coverage.
Example. Bryce works for ABC Co. and participates in its group health plan. When his hours are cut below the plan’s eligibility threshold, he experiences a qualifying event for COBRA purposes. He gets his COBRA election notice on April 1, 2020. What is the deadline for Bryce to elect COBRA?
Answer. The outbreak period is disregarded for purposes of determining Bryce’s COBRA election period. Assume that the national emergency ends on June 30, 2020, so the Outbreak Period ends on August 29, 2020 (60 days later). The last day of his COBRA election period is October 28, 2020.
COBRA Premium Period Extended
Here’s how the extended timeframe works for paying COBRA premium.
Example 1. When the Outbreak Period begin on March 1, 2020, Ray was receiving COBRA continuation coverage under a group health plan. His monthly premium payments are due by the first of the month. Ray made a timely February payment, but he did not make the March payment or any subsequent payments during the Outbreak Period. As of July 1, Ray has made no premium payments for March, April, May, or June. Does Ray lose COBRA coverage, and if so for which month(s)?
Answer. Assume that the national emergency ends on April 30, 2020, with the Outbreak Period ending on June 29, 2020 (the 60 th day after the end of the national emergency). Payments for March, April, May, and June are all deemed to be timely if they are made by July 29, 2020 (30 days after the end of the 60-day period following the Outbreak Period). Ray is eligible to receive coverage under the terms of the plan during this interim period even though some or all of Ray’s premium payments may not be received until July 29, 2020.
Example 2. Now assume that by July 29, 2020, Ray made a payment equal to two months’ premiums. For how long does Ray have COBRA continuation coverage?
Answer. Ray is entitled to COBRA continuation coverage for March and April of 2020, the two months for which he made timely premium payments. However, he is not entitled to COBRA continuation coverage for any month after April 2020.
Extensions Can Cause Administrative Headaches
There may be administrative challenges around these extended deadlines for employers and plan providers, especially when it comes to providing notices to employees. They should take steps immediately to make sure that participants are aware of their extended deadlines.
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By Nitasha Kadam, J.D.