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THE END OF THE COVID-19 EMERGENCY DECLARATION AND YOUR PLAN

June 1, 2023


Citing current COVID-19 trends, the Department of Health and Human Services
(HHS) is preparing for the federal Public Health Emergency (PHE) for COVID-19,
established under Section 319 of the Public Health Service Act, to end on May
11, 2023.

While the virus that causes COVID-19 continues to be a public health priority,
the results of a vaccination program and other efforts to combat the virus have
warranted a downgrade from the emergency phase, according to the HHS. With this
updated status comes several changes employers and benefits managers should keep
in mind.

What won’t change at the end of the PHE?

COVID-19 vaccines will still be covered by the plan without cost share, which is
required under the CARES Act. The Advisory Committee on Immunizations Practices
(ACIP) also classifies the vaccine as a preventive benefit, which typically has
no cost share for members.

What will change at the end of the PHE?

 * Private insurance will not be required to cover COVID-19 tests without cost
   share. However, a plan sponsor can choose to add cost share to the COVID-19
   laboratory test.
 * Coverage can either be added or denied for over-the-counter take home testing
   kits.
 * Language from general plan limitations will be updated to remove time
   extensions referencing “the Outbreak Period” (defined as the period beginning
   March 1, 2020 and ending 60 days after the end of the COVID-19 National
   Emergency), for adverse benefit determinations, special election period
   enrollment and COBRA election periods, etc.

What Is Custom Design Benefits doing to help you prepare for the end of the PHE?

Custom Design Benefits drafted plan amendment and summary of material
modifications for the 2019 Novel Coronavirus (COVID-19) that required no cost
share for immunizations, testing, telehealth, and qualified Coronavirus
Preventive Services.  Details can be found in your SPD (Summary Plan
Description) document that fully explain the changes COVID-19 added to the plan.

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