During the COVID-19 national emergency, the claims and appeals deadlines for various employee benefit plans were extended by disregarding the COVID-19 “outbreak period,” which ends 60 days after the national emergency ends unless federal agencies announce another end date. As of April 10, 2023, the COVID-19 national emergency has ended, putting the outbreak period end date on June 10, 2023. However, the U.S. Department of Labor (DOL) has commented in its FAQS issued in March 2023 that the outbreak period will formally end on July 10, 2023, signally, that they will continue to use May 11, 2023, as the informal end of the national emergency, rather than April 10, 2023.
Outbreak period relief extended deadlines for individuals to file claims for benefits and appeals of adverse benefit determinations under employee benefit plans subject to ERISA or the Code. These plans include retirement, group health, disability, and other employee benefit plans. For group health plans, outbreak period relief also included deadlines for requesting external review following the exhaustion of internal review procedures and perfecting incomplete requests for review.
Now that the COVID-19 national emergency has ended, the disregarded period ends one (1) year after the individual became eligible for outbreak period relief or the end of the outbreak period, whichever comes first. After the disregarded period ends, the regular timeframes and deadlines apply. Therefore, the deadlines for each case may differ.
Differing interpretations of these guidelines exist and could produce varying results based on the circumstances. Since federal agencies encouraged plans to allow plan participants and beneficiaries more rather than less time to act, plans generally should choose the interpretation that results in later deadlines. However, regardless of the interpretation plans choose, they should apply the same interpretation consistently to all cases and communicate clearly with plan participants and beneficiaries.
Finally, the DOL did not expressly grant plans more time to process and decide claims during the COVID-19 emergency. However, it acknowledged that the situation might cause challenges with full and timely compliance with ERISA requirements. Nonetheless, as the COVID-19 emergency has now ended, it is unlikely that DOL would entertain the untimely processing of claims.
HBL has experience in all areas of benefits and employment law, offering a comprehensive solution to all your business benefits and HR/employment needs. We help ensure you are in compliance with the complex requirements of ERISA and the IRS code, as well as those laws that impact you and your employees. Together, we reduce your exposure to potential legal or financial penalties. Learn more by calling 470-571-1007.
Hall Benefits Law, LLC
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