CalPERS Applies COVID-19 Relief Rule Regarding Timeframe Extensions For Special Enrollment Periods And COBRA Elections During The Federally Declared National Emergency Period

CATEGORY: Client Update for Public Agencies, Public Education Matters
CLIENT TYPE: Public Education, Public Employers
DATE: Dec 28, 2020

On May 5, 2020, the IRS and U.S. Department of Labor published the “COVID-19 Relief Rule” (85 FR 26351), providing extended health insurance enrollment periods and coverage for certain plans.  Specifically, the COVID-19 Relief Rule extends the 60-day window periods for 1) providing evidence of a specific qualifying event (such as new enrollment due to loss of coverage or adding a dependent due to marriage, birth, adoption, or placement for adoption) for enrolling for health coverage after the initial enrollment period (i.e., a “special enrollment period”); and 2) to elect continued health coverage through COBRA. These extensions will run from March 1, 2020, until 60 days after the announced end of the national emergency.

Note, these extension of time frames are not mandatory for non-Federal governmental plans, although government agencies such as the U.S. Department of Health and Human Services are encouraging plan sponsors of non-Federal governmental plans to provide relief to participants and beneficiaries similar to that specified in the COVID-19 Relief Rule.  If a local government plan decides to implement these extensions, we recommend doing so for all employees to avoid potential discrimination claims, or at the very least based on the criteria outlined in the COVID-19 Relief Rule.  Employers will need to carefully work with their insurance provider companies to arrange for these extensions if they decide to do so.

CalPERS has waived the 60-day limitations for special enrollment periods and COBRA elections during the national emergency period and confirmed all contracted health plan partners would comply with the COVID-19 Relief Rule.  (See, CalPERS Circ. Letter 600-039-20.

CalPERS stated that members may execute and submit a signed and notarized CalPERS Affidavit of Marriage/Domestic Partnership if they are unable, due to extenuating circumstances, to produce a marriage certificate or domestic partnership registration.  Additionally, if a member is unable to obtain a government-issued birth certificate for a dependent child due to COVID-19, the member may provide a hospital birth record to facilitate the enrollment and provide the government-issued birth certificate once it is available.

CalPERS also stated that health benefit officers (HBOs) are responsible for applying the extensions to eligible employees and family members and processing the transactions.  HBOs should contact CalPERS for assistance with processing new enrollments due to loss of coverage and/or adding a newly acquired dependent if the event and date of received enrollment requests are more than 60 days apart.

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