Why this matters

This public health emergency declaration is important to group health plan sponsors because it determines the period during which group health plans and insurers must pay for COVID-19 tests (including certain over-the-counter tests) and related services without charging cost sharing. In addition, group health plans and insurers must cover COVID-19 vaccines without cost-sharing both in and out of network. After the public health emergency expires, only non-grandfathered plans must cover vaccines and may limit coverage to in-network providers. To learn more, see our December 15, 2020 insight, “Most Plans Must Cover COVID-19 Vaccine Without Cost Sharing.”

Plan sponsors should ensure plans are administered consistently with the requirements for the public health emergency.

Earlier this year, the National Emergency was extended into 2023

Other plan requirements, most notably the requirement to extend certain deadlines related to COBRA, special enrollment, and claims and appeals, are pegged to a different COVID-19 emergency declaration — the national emergency. President Trump made that declaration on March 13, 2020, retroactive to March 1, 2020. That emergency declaration does not expire automatically. On February 18, 2022, President Biden extended the national emergency until March 1, 2023.