End of National Emergencies Means End of Pandemic-Era Relief Measures
On January 30, 2023, the Biden Administration announced its intent to end the COVID-19-related National Emergency and Public Health Emergency, effective May 11, 2023. On April 10, 2023, however, President Biden signed legislation, which ended the National Emergency immediately. The Public Health Emergency is still expected to end on May 11, 2023.
The end of these emergency periods means that certain pandemic-era relief measures under the Directors Guild of America Producer Health Plan (the “Health Plan” or “Plan”) will also end, effective as listed in the chart below.
| REFLIEF MEASURE | END DATE |
| Extension of deadlines for required Health Plan notices, claims and appeals, special enrollment, and COBRA. This relief temporarily provides participants extra time to file claims and meet certain deadlines related to appeals, special enrollments, and enrollment in COBRA, and the Plan with additional time to provide required notices and information. Under this relief, applicable deadlines can be tolled or suspended until the earlier of: (1) one year from the date the individual or Plan was first eligible for relief; or (2) 60 days after the announced end of the National Emergency period. This relief applies to the Health Plan from March 1, 2020 to July 10, 2023 (based on the previously announced National Emergency end date by the Department of Labor and Treasury Department in FAQs, Part 58). | July 10,2023 |
| Cost sharing waived for COVID-19 related testing. Effective for services and supplies rendered on or after March 18, 2020, all patient cost sharing (i.e., deductibles, co-pays and co-insurance) and prior-authorizations have been waived for all testing for the detection and diagnosis of the COVID-19 virus and COVID-19 antibodies. This means you pay no cost-sharing for these services, regardless of whether they are provided in-person or via telemedicine/telepsychology and regardless of whether they are provided in-network or out-of-network when provided following an individualized health assessment by a healthcare provider. | May 11, 2023 Applies to all over-the-counter tests and elective COVID-19 testing. Beginning May 11, 2023, coverage for all over-the-counter and elective COVID-19 testing is eliminated. The Health Plan will continue to cover medically necessary COVID-19 testing (excluding over-the-counter tests) from network and non-network providers in accordance with Health Plan rules and cost-sharing. |
| Coverage of at-home COVID-19 tests. Beginning January 15, 2022 and throughout the Public Health Emergency, the Health Plan is required to cover, with no cost-sharing, at-home COVID-19 tests purchased for personal use without a doctor’s order or individual health assessment for covered participants and their eligible dependents. Tests purchased for employment, school and testing for public health surveillance or for any other purpose not intended for individualized diagnosis are not covered. | May 11, 2023 Applies to all over-the-counter tests and elective COVID-19 testing. Beginning May 11, 2023, coverage for all over-the-counter COVID-19 testing is eliminated. The Health Plan will continue to cover medically necessary COVID-19 testing (excluding over-the-counter tests) from network and non-network providers in accordance with Health Plan rules and cost-sharing. |
| Coverage of COVID-19 vaccinations. Effective March 27, 2020, the Health Plan is required to cover 100% of the costs of any qualifying coronavirus preventive service, including a vaccine, without cost-sharing whether it was provided by a network or non-network provider. | May 11, 2023 Applies to non-network providers only. Beginning May 11, 2023, COVID-19 vaccinations from nonnetwork providers return to the usual rates: 30-40% of the Reasonable and Customary cost. The Health Plan will continue to cover network COVID-19 vaccination costs at 100% as required for preventive care services. |
