FEDERAL GUIDANCE FOR GROUP HEALTH BENEFIT PLANS

Federal Guidance for Group Health Benefit Plans

The federal government has issued new guidance affecting employer-sponsored, self-funded health benefit plans:

New COBRA Model Notices and FAQs
The U.S. Department of Labor released new model COBRA notices that became effective May 1, 2020.

The revised model notices provide additional information to address COBRA’s interaction with Medicare. The model notices explain that there may be advantages to enrolling in Medicare before, or instead of, electing COBRA. It also highlights that if an individual is eligible for both COBRA and Medicare, electing COBRA coverage may impact enrollment into Medicare as well as certain out-of-pocket costs.

The FAQs about the new COBRA model notices answer where to find the new notices and the following additional two questions:

Q2: I didn’t enroll in Medicare when I first became eligible because I was still employed, but I recently lost my job. Can I enroll in Medicare now after my group health plan coverage ends?

Q3: What health coverage pays first if I’m enrolled in both Medicare and COBRA?

For more information, follow this link.

EBSA Disaster Relief Notice 2020-01
EBSA Disaster Relief Notice 2020-01 discusses extensions for Plan fiduciaries to issue notices, disclosures and other documents required by Title I of ERISA (includes Plan documents and SBCs), except for those notices and disclosures addressed in the joint U.S. Department of Labor (DOL)/IRS extension of certain time frames, that are due between March 1, 2020, and 60 days after the announced end of the COVID-19 national emergency if the plan and responsible fiduciary act in “good faith” and furnish the notice, disclosure or document as soon as administratively practical under the circumstances.

“Good faith” acts include use of electronic alternative means of communicating with plan participants and beneficiaries who the plan fiduciary reasonably believes have effective access to electronic means of communication, including email, text messages and continuous access websites.

In the notice, the administration also explains its approach to enforcement: It will emphasize compliance assistance and involve grace periods and other relief where appropriate, including when physical disruption to a plan or service provider’s principal place of business makes compliance with pre-established timeframes for certain claims’ decisions or disclosures impossible.

The notice was released by the U.S. Employee Benefits Security Administration on April 28, 2020.

For more information about extended deadlines for notices and disclosures, follow this link.

COVID-19 FAQs for Participants and Beneficiaries
The U.S. Department of Labor has released answers to common questions to help employee benefit plan participants and beneficiaries, as well as plan sponsors, and employers, impacted by the COVID-19 outbreak understand their rights and responsibilities under Title I of the Employee Retirement Income Security Act of 1974 (ERISA).

For the department’s answers to common questions, which were released on April 28, 2020, follow this link.