Departments Provide Some Relief to Health Plan Sponsors Facing Looming Year-End Deadlines

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Year-end is always a scramble for health plan sponsors as they go through renewal and open enrollment.  This year was looking to be worse than normal given the impending deadlines for complying with the transparency in coverage regulations (“TiC”) and the numerous changes made by the Consolidated Appropriations Act, 2021 (the “CAA”).  As reflected in our February 16, 2021 blog, Buckle Up! Complying with the Health & Welfare Provisions of the CAA Could be a Wild Ride, most of the CAA deadlines were scheduled to take effect December 27, 2021 or the first plan year beginning on or after January 1, 2022, giving plan sponsors and their service providers scant time to comply.

On August 20, 2021, the Departments of Labor (“DOL”), Health and Human Services (“HHS”), and the Treasury (collectively, the “Departments”) issued FAQ Part 49 delaying some of the deadlines. FAQ Part 49 is a must read for health plan sponsors to understand which deadlines have been delayed, allowing them to focus their efforts on those that have not.  The FAQ also explains when regulations will be issued for various CAA requirements, and indicates the Departments do not expect to issue regulations for other provisions.  In the absence of regulations, health plan sponsors must comply with the requirements of the CAA using a good faith reasonable interpretation of the statute.

We have updated our CAA compliance chart to reflect the delayed effective dates.

It’s worth noting there is no delay for the CAA provision requiring plans to perform a detailed comparative analysis for mental health non-quantitative treatment limits (“NQTLs”) upon request.  This requirement took effect February 10, 2021, as explained in our April 28, 2021 SW Benefits Update, Ready or Not, Mental Health Parity Reporting Has Been Effective Since February 10, 2021.  Furthermore, on August 19, 2021, a DOL representative indicated that this is one of the agency’s highest priorities during an American Bar Association webinar.

DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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