Background

The safe harbor for HSA-qualified HDHPs was created by the Coronavirus Aid, Relief, and Economic Security (CARES) Act. The CARES Act safe harbor permits HDHPs to provide telehealth or other remote-care services before the deductible is met. It took effect on March 27, 2020 for plan years beginning on or before December 31, 2021.

We discussed the CARES Act safe harbor in our March 30, 2020 insight, “Impact of CARES Act on Health Plans.”

The extension

The law renews flexibility for employers or plans using HDHPs with HSAs to provide first-dollar coverage for telehealth services before the deductible is met from April 1, 2022 through December 31, 2022.

The law did not cover the gap between the CARES Act rule and the new law. Consequently, any telehealth services provided between January 1, 2022, and March 31, 2022, are not able to be reimbursed unless the participant has met their deductible.

Under existing statutory and regulatory guidance, plans may continue to reimburse HDHP participants for telehealth services for preventive care, dental or vision care, as well as COVID-19 tests or treatment before the deductible.

Implications for sponsors of HDHPs with HSAs

Plan sponsors should contact their health plan administrator to determine how they are paying for telehealth services during both the January–March gap period and for the rest of 2022.

Plan documents may need to be amended concerning telehealth coverage.

In addition, plan sponsors may need to provide a special communication to plan participants in HPDPs with HSAs about the telehealth extension and the coverage gap.