COVID-19 Questions, Answered.

For many, the deadline will be one year from the original deadline. For others, this date is based upon the end of the outbreak period.

Your normal time period for elections, payments, and other notifications remains intact, but it excludes the outbreak period. The outbreak period began on March 1, 2020 and ends on July 10, 2023. Deadline extensions are subject to a maximum extension of 365 days and are applied on an individual basis. This means that some extended deadlines will be 365 days from the original deadline unless the national emergency ends before the 365-day extension window ends.

Below are examples of deadlines based on the outbreak period end date of July 10, 2023:

• Qualified beneficiaries whose election period was April 1, 2022, through May 30, 2022, would be able to elect COBRA coverage through May 30, 2023. While the outbreak period continues after this date, they would have reached the maximum 365-day extension.
• Qualified beneficiaries whose election period is April 1, 2023, through May 30, 2023 would be able to elect COBRA coverage through September 8, 2023. These participants would receive the full 60 days of their election period beginning the day after the outbreak period ends. (End of national emergency, May 11, 2023, plus 60 days is the end of the outbreak period, July 10, 2023. Resume counting on July 11, 2023, and apply the 60-day election period, resulting in a new deadline of September 8, 2023.)

Here is a breakdown of standard COBRA deadlines:

• For any event* dates from March 1, 2020 – July 10, 2022, qualified beneficiaries would be eligible for the maximum 1-year extension.
• For any event* dates from July 11, 2022 – July 10, 2023, qualified beneficiaries would be eligible for an extension, with the deadline count beginning on July 11, 2023.
  • For 30-day deadlines, the new deadline would be August 9, 2023.
  • For 45-day deadlines, the new deadline would be August 24, 2023.
  • For 60-day deadlines, the new deadline would be September 8, 2023.
• For any event* dates on or after July 11, 2023, deadline extensions would not be available.

*Event date being any date which starts the counting of a deadline period, for example, the date a qualified beneficiary is sent an Election Notice (or if later, the date of their qualifying event), a premium due date, or the date a qualified beneficiary makes and election (beginning a 45-day deadline to make the first premium payment).

Updated 07/10/2023

The deadline extensions below are the maximum deadline extension if we were to remain under the national emergency However, the deadline extensions would end as of the earlier of the one-year maximum or based upon the end of the outbreak period (July 10, 2023).

In October of 2021, the IRS issued Notice 2021-58 which provides some clarifying guidance regarding the outbreak period extension of certain deadlines under COBRA. Specifically, this new notice clarifies that the deadline extension to elect COBRA runs simultaneously (i.e., at the same time) with the deadline extension to make premium payments. The impact of this is as follows:

• If an individual elected COBRA continuation coverage within the initial 60-day COBRA election timeframe, that individual will have up to one year and 45 days after the date of the COBRA election to make the initial COBRA premium payment.
• If an individual elected COBRA continuation coverage outside of the initial 60-day COBRA election timeframe, that individual generally will have up to one year and 105* days after the date the COBRA notice was provided to make the initial COBRA premium payment.

*The 105 days is based on the 60-day election period + 45-day premium payment period.

Examples with election within the standard 60-day COBRA election period:

Example 1: Full 365-day deadline extension:

A qualified beneficiary has a qualifying event date of 01/01/2022. Their COBRA Election Notice is sent that same day. The qualified beneficiary elects COBRA on 01/15/2022, which is within the standard 60-day election period. Their initial premium payment will be accepted until 03/01/2023 (1 year + 45 days from the COBRA election date of 01/15/2022).

Note that in this example, the initial premium would include payments for January 2022 only. The February 2022 premium would be due no later than 03/03/2023 (1 year + 30-day grace period from original 02/01/2022 due date).

Example 2: End of outbreak reduces deadline extension (end of outbreak period of 7/10/2023):

A qualified beneficiary has a qualifying event date of 09/01/2022. Their COBRA Election Notice is sent that same day. The qualified beneficiary elects COBRA on 09/15/2022, which is within the standard 60-day election period.  Based on the full, 1 year extension, their initial premium payment would have been accepted until 10/30/2023 (1 year + 45 days from the COBRA election date of 09/15/2022), however, due to the end of the outbreak period, this extension would end earlier. The deadline extension would end 08/24/2023. (End of the outbreak period, July 10, 2023. Resume counting on July 11, 2023, and apply the 45-day payment period, resulting in a new deadline of 8/24/2023.)

Examples with election outside standard 60-day COBRA election period:

Example 1: Full 365-day deadline extension:

A qualified beneficiary has a qualifying event date of 01/01/2022. Their COBRA Election Notice is sent that same day. The qualified beneficiary elects COBRA on 08/15/2022, which is during the deadline extension period. Their initial premium payment will be accepted until 04/16/2023 (1 year + 105 days from the qualifying event date of 01/01/2022).

Example 2: End of outbreak reduces deadline extension (end of outbreak period of 7/10/2023):

A qualified beneficiary has a qualifying event date of 09/01/2022. Their COBRA Election Notice is sent that same day.  The qualified beneficiary elects COBRA on 3/15/2023, which is during the deadline extension period. Their initial premium payment will be accepted until the earlier of 1 year + 105 days from the initial notice date (12/14/2023) OR 45-days after the end of the outbreak period (08/24/2023). Because the outbreak period ends 7/10/2023, resuming the 45-day payment deadline count on 7/11/2023 results in the earlier deadline of 8/24/2023. This would be the new premium payment deadline.

Updated 07/10/2023

The April 2020 guidance did not require plans to proactively contact qualified beneficiaries to notify them of this relief. At that time, we added a short statement to certain COBRA communications that provided notice of an election or payment deadline for awareness. We recently updated this statement to include more specific information based on new guidance in the EBSA Disaster Relief Notice 2021-01.

Additionally, the 2021 guidance indicates that plan administrators should consider sending a notice to all impacted individuals informing them of the deadline extensions, their rights under the extensions, and when the extensions end. You can access a notice template by logging into your employer online account and navigating to Resources > Forms and Materials. This template is provided so that you, as the plan administrator, can notify your plan participants of their rights.

Please know that if we receive an election form, notice of disability determination, or payment beyond a March 1, 2020, or later deadline, we will process it in compliance with the extending rule.

EBC will resume counting and enforcing applicable deadlines suspended during the outbreak period on July 11, 2023, with no extensions.

Updated 07/10/2023

If a COBRA qualified beneficiary submits a late payment or election notice, we are ready to process it and issue appropriate notice to their insurance carriers. Coverage won’t be reinstated before the payment is received, but once we receive payment, coverage will be retroactive to the date coverage was lost.

EBC will resume counting and enforcing applicable deadlines suspend during the outbreak period on July 11, 2023, with no extensions.

Updated 07/10/2023

The DOL and IRS relief only requires the acceptance of late payments, notice of changes, and elections. It does not require coverage to be maintained without payment. Unless and until the DOL and IRS issue clarifications, we think it is a reasonable interpretation of the rule to proceed as usual with respect to coverage and wait to take action to place coverage retroactive to the first missed payment period, without proactively continuing coverage in the absence of payment.

EBC will resume counting and enforcing applicable deadlines suspend during the outbreak period on July 11, 2023, with no extensions.

Updated 07/10/2023

The DOL and IRS relief only mandates non-enforcement of election, notice, and payment deadlines, requiring plans to accept late submissions. It does not require plans to accept requests for extensions. Unless this changes with subsequent clarification from the DOL and IRS, a qualified beneficiary will only receive an extension once an election and/or payment have been submitted.

Therefore, it is best for a qualified beneficiary to send in their election and payment as soon as possible so that coverage can be reinstated. Coverage will not be reinstated until the election is made and at least one month’s premium has been submitted.

EBC will resume counting and enforcing applicable deadlines suspend during the outbreak period on July 11, 2023, with no extensions.

Updated 07/10/2023

Once a qualified beneficiary is outside their original payment grace period, their coverage will terminate, and access will end. To get coverage reinstated, the qualified beneficiary will need to submit a check payment if their online access has been shut off. Once payment is received, their coverage will be reinstated and their online access restored, enabling future credit card payments within the standard payment grace periods.

EBC will resume counting and enforcing applicable deadlines suspend during the outbreak period on July 11, 2023, with no extensions.

Updated 07/10/2023

EBSA Disaster Relief Notice 2021-01 advises that a plan administrator (or responsible plan fiduciary) should consider affirmatively sending a notice regarding the end of the relief period. As your service provider, we are providing you with a static notice that you can use to notify your plan participants of their rights, including information on when the specific deadline extensions applicable to the participant will end.

The Department of Labor encourages you to consider providing a notice to all individuals who may have been impacted by these deadline extensions. You may choose to use our static notice or create your own.

To access our template notice:

1. Log in to your employer online account
2. In the menu, locate the Resources section and click Forms and Materials
3. Click The BESTflex Plan
4. In the Legal Documents section, click BESTflex Plan Participant COVID-19 Deadline Extension Notice to download the PDF document

This notice should be provided to any plan participant who meets one or more of the following requirements during the outbreak period, beginning on March 1, 2020, and ending July 10, 2023.

• Had a claim submission deadline (end of runout period)
• Had the potential of receiving a claim denial notice
• Any new participants who enroll
• Benefits-eligible employees who may have enrolled themselves or a dependent in coverage due to a HIPAA special enrollment right
• Any employees who become newly eligible to participate in the plan

Provide this notice in the same manner as other plan documents and notices. To determine whether you can provide this notice electronically, please refer to www.ebcflex.com/Notices.

Added 07/10/2023

On February 26, 2021, the DOL released additional guidance clarifying the definition of the outbreak period and deadlines. Per the new guidance, Employee Benefit Security Administration (ESBA) Disaster Relief Notice 2021-01, the maximum extension is 365 days based on statutory limits and the limit is applied on an individual basis (i.e., the 365-day clock starts at the beginning of the extended deadline period and not at the beginning of the outbreak period).

The normal runout period remains intact for the Health Care FSA and/or HRA, but it excludes the outbreak period. The outbreak period began on March 1, 2020 and ends 60 days after the end of the national emergency (planned to be May 11, 2023), or any other date announced by the DOL and IRS in subsequent guidance, whichever is shorterJuly 10, 2023. Deadline extensions are subject to a maximum extension of 365 days and are applied on an individual basis. This means that some extended deadlines will be 365 days from the original deadline unless the national emergency ends before the 365- day extension window ends.

Below are examples of deadlines based on the outbreak period end date of July 10, 2023:

• Health Care FSA participants of a 2021 calendar year plan with a three-month runout period that would have ended on March 31, 2022, would be able to submit claims for reimbursement through March 31, 2023. While the outbreak period continues after this date, they would have reached the maximum 365-day extension from the original deadline.
• Health Care FSA participants of a 2022 calendar year plan with a three-month runout period that would have ended on March 31, 2023, would be able to submit claims through October 10, 2023. These participants would receive the full three months of runout beginning the day after the outbreak period ends, which means the runout period begins on July 11, 2023.

Here is a breakdown of runout period deadlines, based on a three-month runout period:

• For any plan years that end March 1, 2020 – July 10, 2022, participants would be eligible for the maximum 1-year extension, resulting in a 1-year and 3-month runout period.
• For any plan years that end July 11, 2022 – July 10, 2023, participants would be eligible for a shorter extension, with the claim submission deadline being October 10, 2023.
• For any plan years that end on or after July 11, 2023, deadline extensions would not be available.

Updated 07/10/2023

Yes. Participants typically have 180 days after a claim denial to appeal the decision. Now, when counting the 180 days, the outbreak period is excluded from the count, up to 365 days from the original deadline unless the outbreak period ends before that date. The outbreak period began on March 1, 2020 and ends July 10, 2023. This means that plans would resume counting appeal deadlines beginning July 11, 2023 (the day after the end of the outbreak period).

Updated 07/10/2023

Yes. All participants whose Health Care FSA or EBC HRA runout period ended on or after March 1, 2020, can submit additional claims that were incurred during the prior plan year for an extended runout period. A plan’s runout period would be counted starting with the earlier date of 365 days from the original start of the runout period or July 10, 2023, (the end of the outbreak period). Employers would begin counting their runout periods as of July 11, 2023 unless they already reached the maximum deadline extension of 365 days before the end of the outbreak period.

As always, the Benefits Card should never be used to pay for expenses incurred in the prior plan year.

Updated 07/10/2023

Employers will be invoiced for any runout claims that are approved based on this new rule. After we receive your payment, we will reimburse the claims to your participants. Employers who fund claims via payroll will receive Medical Excess invoices. Employers cannot rely on future payrolls to fund these claims if forfeitures have already been processed. Employers who fund claims only will see these claims on their Claims Register invoices.

At-home COVID-19 tests that are purchased for personal use are an eligible medical expense.

While these over-the-counter tests are eligible for reimbursement from your FSA, they may also be an eligible expense under your health insurance (if purchased on or after 01/15/2022). Tests are NOT eligible for reimbursement from an FSA if they are reimbursed by another source like your health insurance plan. Participants must be diligent in managing this.

Here are some talking points for plan participants:

• If you plan to submit at-home COVID tests to your health insurer for reimbursement, do not use your Benefits Card to purchase the test.
  • The SIGIS list (IIAS system) will allow card swipes that are automatically adjudicated because these are diagnostic tests, regardless of whether or not your health plan will reimburse you.
• In order to save your FSA dollars, submit tests to your health insurer first for reimbursement. Any tests or portion of tests that are paid (or reimbursed) by an insurance carrier are not eligible for payment from your FSA.
  • If the health plan will cap the amount that is eligible for reimbursement and your test costs more or you purchase more tests than are eligible for reimbursement per month by the health plan, the tests may be reimbursable from an FSA.
• Any at-home COVID tests costs that are not paid by your insurance carrier can then be submitted to Employee Benefits Corporation for reimbursement, however, you must note any portions that were already reimbursed, or you plan to have reimbursed elsewhere.
• If you paid for a test with your Benefits Card and would like to submit it to your health insurance, you will need to pay your Health Care FSA back for any amounts that are reimbursed elsewhere. For BESTflex participants, you may pay your Health Care FSA back through the Employee Benefits Corporation website.
• For more information on how your health insurance plan may cover the cost of your at-home tests, please visit www.cms.gov/how-to-get-your-at-home-OTC-COVID-19-test-for-free.

More information on the health insurance coverage of at-home COVID tests:

On January 10, 2022, The Department of Labor released FAQs Part 51 on the Families First Coronavirus Response Act and Coronavirus Aid, Relief, and Economic Security Act implementation.

Based on FAQ Part 51, beginning on January 15, 2022, (and during the public health emergency), insurers and health plans are required to cover over-the-counter (OTC) at-home COVID-19 tests. This coverage through your health insurance is limited to no less than 8 tests per individual per 30-days (or per calendar month), and no less than $12.00 per test. A test pack is counted based on the number of tests contained. For example, a test pack that contains two tests and costs $25.00 would count as 2 tests (against the 8/person) and would be eligible for health insurance coverage of a minimum of $24.00 (2 tests x $12.00/test). The plan or the insurer has the option to offer more generous reimbursement.

Please contact your health insurance provider for specific details on what coverage they provide. Individuals do not need a health care provider’s authorization or an order to purchase these tests.

The tests covered by the insurance are not subject to any cost-sharing up to the allowable test coverage limits (up to 8 per individual per month, up to $12.00 per test). Insurers can cover more than these minimums, but not less. Insurers cannot limit where a participant can purchase a test – however, insurers may establish direct-pay options with selected merchants that sell at-home tests. If a participant purchases a test from a direct-pay provider, they may not have to pay for the test at point of sale. If a participant purchases a test from another provider, they may be required to submit a claim with reasonable documentation for reimbursement.

While these OTC tests are eligible from your standard health FSA, they may also be an eligible expense under your health insurance. Tests are NOT eligible for reimbursement from the FSA if they are reimbursed by another source like your health insurance plan. Participants must be diligent in managing this.

On February 4, 2022, The Department of Labor released an additional FAQ Part 52, which provides additional guidance as well as addresses interactions with Health Care FSAs, HRAs, and HSAs in Q/A 5. Based on the guidance in this FAQ, employers may wish to notify individuals about the coordination of the group health plans and Health Care FSAs, and caution participants against using the Benefits Card to purchase OTC COVID-19 tests.

After the end to the public health emergency on May 11, 2023, insurance plans will no longer be required to cover OTC COVID-19 tests with a $0 out-of-pocket expense but could choose to continue to do so. Any out-of-pocket costs for OTC COVID-19 tests will continue to be an eligible medical expense under the Health Care FSA, HRA, and HSAs after May 11, 2023.

Updated 07/10/2023

Personal protective equipment (PPE) purchased for the primary purpose of preventing the spread of COVID-19 is treated as an eligible medical expense. Eligible PPE expenses include face masks (disposable and cloth) that are multiple layers and have a nose wire, hand sanitizer that is at least 60% alcohol, and hand sanitizing wipes that are 60-95% alcohol.

Face shields, neck gaiters, or face masks with vents/valves are not eligible. Household cleaning products, including surface cleaning wipes, are not eligible. See IRS Announcement 2021-7 for more details.

Amounts associated with these types of expenses incurred on or after January 1, 2020, can be reimbursed by a Health Care flexible spending account (FSA), a health reimbursement arrangement (HRA) or a health savings account (HSA) with no plan amendment required.

Updated 07/10/2023

Over-the-counter (OTC) drugs and menstrual care products are eligible expenses for Health Care FSAs, HSAs, and HRAs as part of the Coronavirus Aid, Relief, and Economic Security (CARES) Act.

Our standard BESTflex and EBC HRA Plan Documents and Summary Plan Descriptions (SPDs) have been updated to clarify OTC rules and allow reimbursement of menstrual care products for all Health Care FSAs and for HRAs when plan design allows. Log into your online account to find an amended Plan Document (which must be signed in order to adopt the amended and restated plan), as well as an updated SPD and CARES Act Summary of Material Modification that should be provided to all participants in the plan.

Once you’ve adopted the updated documents, your participants can submit claims for reimbursement for OTC medication and menstrual care expenses purchased on or after January 1, 2020.

The deadline to adopt the amendment, in order for it to be effective January 1, 2020, was December 31, 2021.

Updated 02/09/2023

You can find a list of eligible FSA, HSA, and HRA expenses at www.ebcflex.com/EligibleExpenses.

Yes. The Benefits Card auto-approves items for purchase based on the Inventory Information Approval System (IIAS), an industry-maintained database of eligible items. Merchants and vendors are responsible for submitting specific items to IIAS for approval. Once the items are approved, it takes additional time for the system to be updated and for merchants to receive the updates. All of these steps must be completed before items are automatically approved as Benefits Card purchases (eliminating the need for participants to submit documentation on the purchase). If a participant has a difficult time purchasing a particular product with the card, we recommend they use another form of payment to purchase the item and submit an online claim for reimbursement.

EBSA Disaster Relief Notice 2021-01 advises that a plan administrator (or responsible plan fiduciary) should consider affirmatively sending a notice regarding the end of the relief period. As your service provider, we are providing you with a static notice that you can use to notify your plan participants of their rights, including information on when the specific deadline extensions applicable to the participant will end.

We encourage you to consider providing a notice to all individuals who may have been impacted by these deadline extensions. You may choose to use our static notice or create your own.

To access our template notice:

1. Log in to your employer online account
2. In the menu, locate the Resources section and click Forms and Materials
3. Click EBC HRA
4. In the Legal Documents section, click EBC HRA Participant COVID-19 Deadline Extension Notice to download the PDF document

This notice should be provided to any plan participant who meets one or more of the following requirements during the outbreak period, beginning on March 1, 2020 and ending July 10, 2023.

• Had a claim submission deadline (end of runout period)
• Had the potential of receiving a claim denial notice
• Any new participants who enroll
• Benefits-eligible employees who may have enrolled themselves or a dependent in coverage due to a HIPAA special enrollment right
• Any employees who become newly eligible to participate in the plan

Provide this notice in the same manner as other plan documents and notices. To determine whether you can provide this notice electronically, please refer to www.ebcflex.com/Notices.

Added 07/10/2023

On February 26, 2021, the DOL released additional guidance clarifying the definition of the outbreak period and deadlines. Per the new guidance, Employee Benefit Security Administration (ESBA) Disaster Relief Notice 2021-01, the maximum extension is 365 days based on statutory limits and the limit is applied on an individual basis (i.e., the 365-day clock starts at the beginning of the extended deadline period and not at the beginning of the outbreak period).

The normal runout period remains intact for the Health Care FSA and/or HRA, but it excludes the outbreak period. The outbreak period began on March 1, 2020, and July 10, 2023. Deadline extensions are subject to a maximum extension of 365 days and are applied on an individual basis. This means that some extended deadlines will be 365 days from the original deadline, unless the national emergency ends before the 365-day extension window ends.

Below are examples of deadlines based on the outbreak period end date of July 10, 2023:

• HRA participants of a 2021 calendar year plan with a three-month runout period that would have ended on March 31, 2022, would be able to submit claims for reimbursement through March 31, 2023. While the outbreak period continues after this date, they would have reached the maximum 365-day extension from the original deadline.
• HRA participants of a 2022 calendar year plan with a three-month runout period that would have ended on March 31, 2023, would be able to submit claims through October 10, 2023. These participants would receive the full three months of runout beginning the day after the outbreak period ends, which means the runout period begins on July 11, 2023. 

Here is a breakdown of runout period deadlines, based on a three-month runout period:

• For any plan years that end March 1, 2020 – July 10, 2022, participants would be eligible for the maximum 1-year extension, resulting in a 1-year and 3-month runout period.
• For any plan years that end July 11, 2022 – July 10, 2023, participants would be eligible for a shorter extension, with the claim submission deadline being October 10, 2023.
• For any plan years that end on or after July 11, 2023, deadline extensions would not be available.

Updated 07/10/2023

Yes. Participants typically have 180 days after a claim denial to appeal the decision. Now, when counting the 180 days, the outbreak period is excluded from the count, up to 365 days from the original deadline unless the outbreak period ends before that date. The outbreak period began on March 1, 2020 and ends July 10, 2023. This means that plans would resume counting appeal deadlines beginning July 11, 2023 (the day after the end of the outbreak period).

Updated 07/10/2023

Yes. All participants whose Health Care FSA or EBC HRA runout period ended on or after March 1, 2020, can submit additional claims that were incurred during the prior plan year for an extended runout period. A plan’s runout period would be counted starting with the earlier date of 365 days from the original start of the runout period or July 10, 2023, (the end of the outbreak period). Employers would begin counting their runout periods as of July 11, 2023 unless they already reached the maximum deadline extension of 365 days before the end of the outbreak period.

As always, the Benefits Card should never be used to pay for expenses incurred in the prior plan year.

Updated 07/10/2023

At-home COVID-19 tests that are purchased for personal use are an eligible medical expense.

If your HRA reimburses OTC expenses, these OTC tests are eligible for reimbursement from your HRA. However, they may also be an eligible expense under your health insurance (if purchased on or after 01/15/2022). Tests are NOT eligible for reimbursement from an HRA if they are reimbursed by another source like your health insurance plan. Participants must be diligent in managing this.

Here are some talking points for plan participants:

• If you plan to submit at-home COVID tests to your health insurer for reimbursement, do not use your Benefits Card to purchase the test.
  • The SIGIS list (IIAS system) will allow card swipes that are automatically adjudicated because these are diagnostic tests, regardless of whether or not your health plan will reimburse you.
• In order to save your HRA dollars, submit tests to your health insurer first for reimbursement. Any tests or portion of tests that are paid (or reimbursed) by an insurance carrier are not eligible for payment from your HRA.
  • If the health plan will cap the amount that is eligible for reimbursement and your test costs more or you purchase more tests than are eligible for reimbursement per month by the health plan, they may be reimbursable from the HRA.
• Any at-home COVID tests costs that are not paid by your insurance carrier can then be submitted to Employee Benefits Corporation for reimbursement, however, you must note any portions that were already reimbursed, or you plan to have reimbursed elsewhere.
• If you paid for a test with your Benefits Card and would like to submit it to your health insurance, you will need to pay your HRA back for any amounts that are reimbursed elsewhere. You may pay your HRA back though the Employee Benefits Corporation website.
• For more information on how your health insurance plan may cover the cost of your at-home tests, please visit cms.gov/how-to-get-your-at-home-OTC-COVID-19-test-for-free

More information on the health insurance coverage of at-home COVID tests:

On January 10, 2022, The Department of Labor released FAQs Part 51 on the Families First Coronavirus Response Act and Coronavirus Aid, Relief, and Economic Security Act implementation.

Based on FAQ Part 51, beginning on January 15, 2022 (and during the public health emergency), insurers and health plans are required to cover over-the-counter (OTC) at-home COVID-19 tests. This coverage through your health insurance is limited to no less than 8 tests per individual per 30-days (or per calendar month), and no less than $12.00 per test. A test pack is counted based on the number of tests contained. For example, a test pack that contains two tests and costs $25.00 would count as 2 tests (against the 8/person) and would be eligible for health insurance coverage of a minimum of $24.00 (2 tests x $12.00/test). The plan or the insurer has the option to offer more generous reimbursement.

Please contact your health insurance provider for specific details on what coverage they provide. Individuals do not need a health care provider’s authorization or an order to purchase these tests.

The tests covered by the insurance are not subject to any cost-sharing up to the allowable test coverage limits (up to 8 per individual per month, up to $12.00 per test). Insurers can cover more than these minimums, but not less. Insurers cannot limit where a participant can purchase a test – however, insurers may establish direct-pay options with selected merchants that sell at-home tests. If a participant purchases a test from a direct-pay provider, they may not have to pay for the test at point of sale. If a participant purchases a test from another provider, they may be required to submit a claim with reasonable documentation for reimbursement.

While these OTC tests are eligible from your HRA, they may also be an eligible expense under your health insurance. Tests are NOT eligible for reimbursement from the HRA if they are reimbursed by another source like your health insurance plan. Participants must be diligent in managing this.

On February 4, 2022, The Department of Labor released an additional FAQ Part 52 which provides additional guidance as well as addresses interactions with Health Care FSAs, HRAs, and HSAs in Q/A 5. Based on the guidance in this FAQ, employers may wish to notify individuals about the coordination of the group health plans and HRAs, and caution participants against using the Benefits Card to purchase OTC COVID-19 tests.

After the end to the public health emergency on May 11, 2023, insurance plans will no longer be required to cover OTC COVID-19 tests with a $0 out-of-pocket expense but could choose to continue to do so. Any out-of-pocket costs for OTC COVID-19 tests will continue to be an eligible medical expense under the Health Care FSA, HRA, and HSAs after May 11, 2023.

Updated 07/10/2023

Personal protective equipment (PPE) purchased for the primary purpose of preventing the spread of COVID-19 is treated as an eligible medical expense. Eligible PPE expenses include face masks (disposable and cloth) that are multiple layers and have a nose wire, hand sanitizer that is at least 60% alcohol, and hand sanitizing wipes that are 60-95% alcohol.

Face shields, neck gaiters, or face masks with vents/valves are not eligible. Household cleaning products, including surface cleaning wipes, are not eligible. See IRS Announcement 2021-7 for more details.

Amounts associated with these types of expenses incurred on or after January 1, 2020, can be reimbursed by a Health Care flexible spending account (FSA), a health reimbursement arrangement (HRA) or a health savings account (HSA) with no plan amendment required.

Updated 04/08/2021

You can find a list of eligible FSA, HSA, and HRA expenses at www.ebcflex.com/EligibleExpenses.

Over-the-counter (OTC) drugs and menstrual care products are now eligible expenses for Health Care FSAs, HSAs, and HRAs as part of the Coronavirus Aid, Relief, and Economic Security (CARES) Act.

We’ve updated our standard BESTflex and EBC HRA Plan Documents and Summary Plan Descriptions (SPDs) to clarify OTC rules and allow reimbursement of menstrual care products for all Health Care FSAs and for HRAs when plan design allows. Log into your online account to find an amended Plan Document (which must be signed in order to adopt the amended and restated plan), as well as an updated SPD and CARES Act Summary of Material Modification that should be provided to all participants in the plan.

Once you’ve adopted the updated documents, your participants can submit claims for reimbursement for OTC medication and menstrual care expenses purchased on or after January 1, 2020.

The deadline to adopt the amendment, in order for it to be effective January 1, 2020, was December 31, 2021.

Updated 02/09/2023

Yes. The Benefits Card auto-approves items for purchase based on the Inventory Information Approval System (IIAS), an industry-maintained database of eligible items. Merchants and vendors are responsible for submitting specific items to IIAS for approval. Once the items are approved, it takes additional time for the system to be updated and for merchants to receive the updates. All of these steps must be completed before items are automatically approved as Benefits Card purchases (eliminating the need for participants to submit documentation on the purchase). If a participant has a difficult time purchasing a particular product with the card, we recommend they use another form of payment to purchase the item and submit an online claim for reimbursement.

Personal protective equipment (PPE) purchased for the primary purpose of preventing the spread of COVID-19 can now be treated as eligible medical expenses. Eligible PPE expenses include face masks (disposable and cloth) that are multiple layers and have a nose wire, hand sanitizer that is at least 60% alcohol, and hand sanitizing wipes that are 60-95% alcohol.

Face shields, neck gaiters, or face masks with vents/valves are not eligible. Household cleaning products, including surface cleaning wipes, are not eligible. See IRS Announcement 2021-7 for more details.

Amounts associated with these types of expenses incurred on or after January 1, 2020, can be reimbursed by a Health Care flexible spending account (FSA), a health reimbursement arrangement (HRA) or a health savings account (HSA) with no plan amendment required.

Updated 04/08/2021

You can find a list of eligible FSA, HSA, and HRA expenses at www.ebcflex.com/EligibleExpenses.

Over-the-counter (OTC) drugs and menstrual care products are now eligible expenses for Health Care FSAs, HSAs, and HRAs as part of the Coronavirus Aid, Relief, and Economic Security (CARES) Act. The CARES Act allows any HSAs that were open as of January 1, 2020, to reimburse OTC medication and menstrual care expenses purchased on or after that date.

Yes.

Not during the period of time from January 1, 2020, until the end of plan years ending on or before December 31, 2024.

The IRS issued Notice 2020-15, which provides relief for testing and treatment for COVID-19 from being disqualifying coverage for eligibility to contribute to an HSA until further guidance is issued. Health plans are permitted to offer these services before the minimum high deductible health plan (HDHP) deductible has been satisfied. This was further clarified in IRS Notice 2020-29 as effective retroactive to January 1, 2020.

After the planned end to the public health emergency on May 11, 2023, insurance plans will no longer be required to cover OTC COVID-19 tests with a $0 out-of-pocket expense but could choose to continue to do so. Any out-of-pocket costs for OTC COVID-19 tests will continue to be an eligible medical expense under the Health Care FSA, HRA, and HSAs after May 11, 2023.

The IRS issued IRS Notice 2023-37 on June 23, 2023.  This new guidance modifies Notice 2020-15 as it relates to the relief when paying for COVID-19 testing and treatment, which can currently be paid for below the minimum required HDHP with impacting health savings account (HSA) eligibility. The IRS has indicated that the relief will only apply to plan years ending on or before December 31, 2024. For subsequent plan years, an HDHP is not permitted to provide health benefits associated with testing for and treating COVID-19 without a deductible, or with a deductible below the minimum deductible (for self-only or family coverage) for an HDHP, except as otherwise provided in this notice.

This current notice also clarifies how COVID-19 expenses may or may not be considered preventive care for the purpose of HSA rules. Notice 2004-23 provides that preventive care under section 223(c)(2)(C) includes, but is not limited to, screening services as specified in the Appendix to Notice 2004-23. However, preventive care does not generally include any service or benefit intended to treat an existing illness, injury, or condition, and the safe harbor does not include screenings for common and episodic illness like the flu. The IRS concludes that COVID-19 screening (testing) does not meet the safe harbor and will not be treated as preventive care for purposes of HSAs, effective as of the date of publication of this notice.  Despite this, if the HSA account holder’s HDHP has a plan year ending on or before December 31, 2024, the plan can continue to provide coverage for screenings before satisfying the minimum required HDHP deductible and the HSA account holder can continue to contribute to their HSAs.

In addition, consistent with the position taken in Question and Answer 7 of FAQs About Affordable Care Act and COVID Aid, Relief and Economic Security Act Implementation Part 59, this notice provides that items and services recommended with an “A” or “B” rating by the U.S. Preventive Services Task Force (USPSTF) on or after March 23, 2010, are treated as preventive care for purposes of section 223(c)(2)(C) of the Code, regardless of whether these items and services must be covered, without cost sharing, under PHS Act section 2713. Accordingly, if COVID-19 testing were to be recommended with an “A” or “B” rating by the USPSTF, then that testing would be treated as preventive care under section 223(c)(2)(C) of the Code, regardless of whether it must be covered, without cost sharing, under PHS Act section 2713.

Updated 07/10/2023

There has been various relief that provides for time periods in which telemedicine coverage is not considered disqualifying coverage prior to the minimum HDHP deductible having been satisfied.  The time periods in which telemedicine can be provided immediately without having met the HDHP deductible and not be disqualifying coverage includes:

• Plan years beginning on or after January 1, 2020, through December 31, 2021.
• The months of April 2022 – December 2022, regardless of plan year.
• Plan years beginning after December 31, 2022, and before January 1, 2025 (not including plan years beginning January 1, 2025).

With each legislative action, there have been gaps created in which telemedicine coverage provided before the minimum HDHP deductible would be considered as disqualifying coverage. Employers must work with their insurers to be sure that HSA-qualified HDHPs account for these gaps and do not provide coverage prior to the deductible.

Initial Relief (Plan years beginning on or after January 1, 2020, through December 31, 2021):

The CARES Act clarified that participants in an HSA-qualified HDHP can utilize telemedicine services at no cost or reduced cost without this being disqualifying coverage for eligibility to contribute to an HSA. Health plans are permitted to offer these services before the minimum HDHP deductible has been satisfied. This was further clarified in IRS Notice 2020-29 as effective retroactive to January 1, 2020. This temporary relief applies to plans beginning on or before December 31, 2021.

Second Round of Relief (Months of April 2022 – December 2022):

In February 2022, President Biden signed the Consolidated Appropriations Act 2022. CAA 2022 added additional time (April 1, 2022 – December 31, 2022) where telemedicine coverage, prior to the minimum HDHP deductible being satisfied, is not considered disqualifying coverage. This relief is not mandatory. Plans that offer an HSA-qualified HDHP should consult with their insurers to determine if telemedicine will be subject to the plan’s deductible for this period of relief.

• For calendar year plans, this means to be an HSA-qualified plan:
  • January – December 2021: Telemedicine does not need to apply to the minimum HDHP deductible.
  • January – March 2022: Telemedicine must be subject to minimum HDHP deductible.
  • April – December 2022: Telemedicine does not need to apply to the minimum HDHP deductible.
• For off-calendar year plans that began in 2021 and end in January or February 2022, this means to be an HSA-qualified plan:
  • Plan year beginning in 2021 and ending in January 2022.
    • 2021 – January 2022: Telemedicine does not need to apply to the minimum HDHP deductible.
    • February 2022 – March 2022: Telemedicine must be subject to minimum HDHP deductible.
    • April – December 2022: Telemedicine does not need to apply to the minimum HDHP deductible.
  • Plan year beginning in 2021 and ending in February 2022.
    • 2021 – February 2022: Telemedicine does not need to apply to the minimum HDHP deductible.
    • March 2022: Telemedicine must be subject to minimum HDHP deductible.
    • April – December 2022: Telemedicine does not need to apply to the minimum HDHP deductible.
• For off-calendar plan years that began in 2021 and that end on or after 3/31/2022, telemedicine does not need to apply to the minimum HDHP deductible until 12/31/2022.

Third Round of Relief (Plan years beginning after December 31, 2022, and before January 1, 2025).

In December 2022, President Biden signed into law the Consolidated Appropriations Act, 2023. Included in this law was another extension where telehealth services can be paid for under HSA-qualified HDHPs without being subject to the IRS minimum deductible, and without being considered disqualifying coverage for HSAs. This new law provides this relief temporarily for plan years beginning after December 31, 2022, and before January 1, 2025 (not including plan years beginning on January 1, 2025).

Note: Because the relief that applied to certain months in 2022 was month-specific and not tied to plan years, this again leaves a gap in relief as it applies to non-calendar year plan years going forward.

For calendar year plans:

• Because this relief begins with plan years beginning on January 1, 2023, there would not be a gap in relief.

For off-calendar year plans:

• Because the 2022 relief ended in the month of December, regardless of plan year, a gap in relief will occur where telehealth is covered before the minimum required deductible for any months up until the health plan renews in 2023.
  • Example: Plan years beginning in February:
    • April – December 2022: Telehealth does not need to apply to the minimum HDHP deductible.
    • January 2023: Telehealth must be subject to minimum HDHP deductible, or the health plan is considered disqualifying coverage.
    • February 2023 – January 2024 plan year: Telehealth does not need to apply to the minimum HDHP deductible.
    • February 2024 – January 2025 plan year: Telehealth does not need to apply to minimum HDHP deductible.
  • Example: Plan years beginning in July:
    • April – December 2022: Telehealth does not need to apply to the minimum HDHP deductible.
    • January 2023 – June 2023: Telehealth must be subject to minimum HDHP deductible, or the health plan is considered disqualifying coverage.
    • July 2023 – June 2024 plan year: Telehealth does not need to apply to the minimum HDHP deductible.
    • July 2024 – June 2025 plan year: Telehealth does not need to apply to minimum HDHP deductible.

If health plans cannot adjust benefits mid-year due to account for the gap in telehealth relief, or if an employer or insurer elects to ignore the gaps, individuals who contribute to an HSA should be aware of the impact to their eligibility. Individuals can rely on the Last-Month Rule (see Publication 969), if they elect to contribute based on a full year of eligibility, but they should be aware of potential tax consequences if they do not remain eligible during the entire following calendar year.

Updated 07/10/2023

Pre-tax CommuteEase funds that remain in a participant’s account at termination cannot be refunded, and must be forfeited according to IRS regulations. Post-tax contributions can and should be refunded to participants by the employer.