Outbreak Period Defined The “outbreak period” begins on March 1, 2020 and ends 60 days after the announced end of the COVID-19 national emergency. The outbreak period is to be disregarded in the calculation of all deadlines addressed in the guidance. Deadline Extensions COBRA: Multiple COBRA deadlines have been extended until after the outbreak period ends, including: • The 60-day deadline for individuals to notify the plan of a qualifying event • The 60-day deadline for individuals to notify the plan of a SS determination of disability • The 30-day deadline for employers to notify plan administrators of a COBRA qualifying event (44 days when combined with 14 days below) • The 14-day deadline for plan administrators to furnish COBRA election notices (44 days when combined with 30 days above) • The 60-day deadline for participants to elect COBRA • The 45-day deadline in which to make a first premium payment • The 30-day deadline for subsequent premium payments.
HIPAA Special Enrollment: The following HIPAA special enrollment periods are extended:
• The 30-day special enrollment period triggered when eligible employees or dependents lose eligibility for other health plan coverage (in which they were previously enrolled) • The 30-day special enrollment period triggered when an eligible employee acquires a dependent through birth, marriage, adoption, or placement for adoption • The 60-day special enrollment period triggered by changes in eligibility for state premium assistance under the Children’s Health Insurance Program or loss of Medicaid/CHIP eligibility. Claims Procedures: The deadlines are extended for individuals to file claims for benefits, for initial disposition of claims, and for providing claimants a reasonable opportunity to appeal adverse benefit determinations. Group health plans and disability plans generally must allow a 180-day timeframe to appeal, while other plans must allow a 60-day timeframe. External Review and Appeals: Under the ERISA appeals process for non-grandfathered health plans, claimants have four months after the receipt of a notice of adverse benefit determination in which to request an external review. Plan deadlines have been extended to disregard the outbreak period. Other deadlines that apply for completing an incomplete request for review are also extended. Furnishing Notices Plans will not be treated as having violated ERISA if they act in good faith and furnish any notices, disclosures, or documents “as soon as administratively practicable under the circumstances.” This includes all documents that would otherwise have to be furnished during the outbreak period including those requested in writing by a participant or beneficiary.
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