The IRS and Employee Benefits Security Administration (U.S. Labor Department) have jointly issued a final rule to extend certain timeframes concerning participants’ rights to healthcare coverage, portability, and continuation of group health plan coverage under COBRA, and to extend the time for plan participants to file or perfect benefit claims or appeals of denied claims. The extensions are provided as relief measures in response to the coronavirus (COVID-19) pandemic.
The two agencies believe that such relief is immediately needed to preserve and protect the benefits of participants and beneficiaries in employee benefit plans across the US during the National Emergency.
Group health plans, disability and other employee welfare benefit plans, and employee pension benefit plans subject to ERISA or the Code must disregard the period from March 1, 2020 until 60 days after the announced end of the National Emergency or such other date announced by the Agencies in a future notice (the “Outbreak Period”) in determining the following periods and dates –
· The 30-day period (or 60-day period, if applicable) to request special enrollment under ERISA and the Code.
· The 60-day election period for COBRA continuation coverage under ERISA and the Code.
· The date for making COBRA premium payments.
· The date for individuals to notify the plan of a qualifying event or determination of disability under ERISA section 606(a)(3).
· The date within which individuals may file a benefit claim under the plan’s claims procedure.
· The date within which claimants may file an appeal of an adverse benefit determination under the plan’s claims procedure.
· The date within which claimants may file a request for an external review after receipt of an adverse benefit determination or final internal adverse benefit determination.
· The date within which a claimant may file information to perfect a request for external review upon a finding that the request was not complete.
With respect to group health plans, and their sponsors and administrators, the Outbreak Period shall be disregarded when determining the date for providing a COBRA election notice.
Read the final rule [PDF 129 KB] that includes examples of application of the relief measures.
Text of the final rule was posted in advance of publication in the Federal Register on the Labor Department’s website and includes the following statement:
This final rule has been submitted to the Office of the Federal Register (OFR) for publication, and will be placed on public inspection at the OFR and published in the Federal Register. This version of the final rule may vary slightly from the published document if minor technical or formatting changes are made during the OFR review process. Only the version published in the Federal Register is the official final rule
