While California’s COVID-19 state of emergency ended on February 28, 2023, the national COVID-19 Public Health Emergency is still active and will terminate on May 11, 2023. Consumers impacted by the COVID-19 Public Health Emergency may qualify for Special Enrollment using the “Public Health Emergency” Qualifying Life Event to enroll and make changes to their coverage.
The Department of Labor’s Employee Benefits Security Administration (EBSA) is committed to working with employers and other plan sponsors to ensure a smooth transition as the federal government unwinds some of the policies that have been in place during the COVID-19 public health emergency and National Emergency. To partner with you through this process, the Departments of Labor, Health and Human Services, and the Treasury issued guidance today in an effort to ensure that workers and their families are aware of any changes that may be coming their way:
- FAQs Part 58 – https://www.dol.gov/agencies/ebsa/about-ebsa/our-activities/resource-center/faqs/aca-part-58: addresses how the end of the public health emergency affects requirements to cover COVID-19 diagnostic testing and vaccines, as well as how the end of the national emergency affects extensions of certain time frames for employee benefit plans and their participants and families.
- Medicaid-CHIP SEP Options Flyer –https://www.dol.gov/sites/dolgov/files/ebsa/about-ebsa/our-activities/resource-center/publications/losing-medicaid-or-chip-flyer.pdf: important information that you can share with individuals who may lose their Medicaid or Children’s Health Insurance Program (CHIP) coverage after March 31, 2023.
As a reminder, states that administer Medicaid, such as Medi-Cal in California, were prohibited from terminating a beneficiary’s enrollment during the national COVID Public Health Emergency unless they moved out of state, became deceased, or the beneficiary requested a voluntary termination of eligibility. Beginning as of April 1, 2023, the Department of Health Care Services will begin to “unwind” this policy and resume its annual eligibility review process for members enrolled in Medi-Cal, which could possible result in a beneficiary being determined no longer eligible for Medi-Cal. This would allow eligible individuals to enroll in a qualified health plan and possibly gain eligibility for advanced premium tax credits with a July 1, 2023 effective date. The other option for members who lose eligibility with Medi-Cal is they could enroll in their employer group plan (if they meet the employer’s eligibility requirements), as this is a qualifying life event. Please reference Covered California’s Public Health Emergency & Medi-Cal to Marketplace Automatic Enrollment Program Toolkit for additional program information and support materials.
If you have any questions or would like more information, please reach out to MNJ Insurance Solutions.
This summary is provided for informational purposes only and should not be construed as legal or a recommendation of any kind. While we have attempted to provide current, accurate, and clearly expressed information, this information is provided “as is,” and MNJ Insurance Solutions makes no representations or warranties regarding its accuracy and completeness.