COVID-19 National Emergency Relief

Monday, March 22, 2021

Updated 4/15/2021

If I have missed a deadline under MIT during the COVID-19 pandemic, are any special extensions available? 

Yes, MIT offers several key deadline extensions to help you and your family deal with any negative impact that the COVID-19 pandemic may have on your ability to satisfy the deadlines that would normally apply to your rights under the following:

  • COBRA Continuation Coverage(COBRA election, premium payment and notification of qualifying event deadlines) – these are addressed under the heading COBRA Continuation of Medical Care Coverage in our Main SPD
  • HIPAA Special Enrollment Periods (for example, deadline for adding a newborn or a dependent who lost coverage elsewhere) – these are addressed under the heading Election Changes Due to Special Enrollment in our Main SPD.
  • ERISA Claims for Benefits and Appeals of Denied Claims (deadline for filing initial claims and appealing adverse benefit determinations)– these are addressed under the heading Claims and Appeals in our Main SPD and our Medical SPD.
  • External Review of certain Claims pursuant to the ACA (deadline for requesting external review of a denied claim)– these are addressed under the heading Claims and Appeals in our Medical SPD.

Under these extensions, any deadline that would have normally expired on or after March 1, 2020 is extended for 1 year.

Example 1:  If you would have had until September 1, 2020 to elect to enroll in COBRA coverage through MIT, you now have until September 1, 2021 to elect COBRA.

Example 2: If you have a newborn that was born on July 1, 2020 and you would normally have had until August 1, 2020 to enroll him or her in your MIT coverage, you now have until August 1, 2021 to enroll your newborn.

In all events, and even if it is less than 1 year from your original deadline, no extension will apply beyond the date that is 60 days after the announcement of the end of the U.S. COVID-19 National Emergency or such other date as may be announced by the Department of Labor in a future notice (this may be different for different regions of the country).

We hope that these deadline extensions will ensure that you do not suffer an unintended loss or lapse of group health coverage or denial of a valid claim for benefits.

Please note that these deadline extensions reflect the latest guidance from the DOL and IRS, as issued through April 12, 2021.

You can read more on these COVID-19 related deadline extensions here:

https://www.nelsonmullins.com/idea_exchange/alerts/Comp-and-Benefits-Brief/all/don-t-restart-the-clock-just-yet-cobra-hipaa-other-deadlines-might-be-further-extended

https://www.nelsonmullins.com/idea_exchange/alerts/Comp-and-Benefits-Brief/all/don-t-restart-the-clock-just-yet-cobra-hipaa-other-deadlines-might-be-further-extended


 

How are my claims handled while the COVID-19 deadline extensions are in effect?

In general, your claims will not be paid unless and until you both elect and pay for COBRA coverage under MIT.  For example, if you have not elected COBRA coverage or are not current on your premium payment(s) for COBRA coverage, any claim submitted by your physician or other medical provider will be held by MIT until we receive your election for coverage and your required payment.

If we are contacted by your medical provider for verification of coverage during this period, we will explain that you are still within your election period and/or payment period and that coverage will retroactively take effect if your COBRA election and premium payment are received and processed by MIT.

Please note that if you do not elect and pay for COBRA coverage by the end of the deadline extension, you will be responsible for any ineligible claims that were paid by MIT on your behalf during the extended election and/or payment period.

If you want to avoid these delays in claims payment, you should continue to make your elections and pay your premiums on time.

 


 

What are my COBRA Subsidy rights under the American Rescue Plan Act of 2021?

The American Rescue Plan Act of 2021, signed by President Biden on March 11, 2021, includes generous provisions that may allow you and your family members the right to continue your MIT coverage at no cost to you during the period from April 1, 2021 to September 30, 2021 (“ARPA Subsidized COBRA”).

You are eligible for this ARPA Subsidized COBRA if either:

a) you are enrolled in COBRA during any month between April 1 and September 30, 2021 due to an involuntary termination of the covered employee’s employment or reduction of hours (other than for gross misconduct); or

b) prior to April 1, 2021 you became eligible for COBRA due to an involuntary termination of the covered employee’s employment or reduction of hours (other than for gross misconduct), which coverage would have been in place during one or more months between April 1 and September 30, 2021, but either you didn’t elect it or you elected it but then dropped it.

If you are in this second group, we will be sending you a special enrollment election form, which will allow you a chance to re-start your COBRA coverage.  If you choose to restart your coverage, it will take effect on April 1, 2021, unless you elect a later date.  In either case, please note that ARPA Subsidized COBRA is only available for periods of coverage from April 1, 2021 through September 30, 2021.

 


 

Are there any ways that my ARPA Subsidized COBRA can terminate before September 30, 2021?

Yes.  Normally, your ARPA Subsidized COBRA will continue until September 30, 2021.  However, it can terminate earlier if:

a) you become eligible (regardless of enrollment) for coverage under another group health plan (other than an excepted benefit, a QSEHRA, or a health FSA) or Medicare; or

b) your maximum COBRA coverage period expires (based on the date you were originally eligible for COBRA).

You have a duty to notify MIT if you cease to qualify for the ARPA Subsidized COBRA due to having other coverage available.  If you fail to notify MIT as required, you may be subject to a penalty of $250 for each failure (or, where fraudulent, it may increase to 110% of the premium assistance provided after you were no longer eligible).

 


 

How Do the ARPA Subsidized COBRA rules interact with the COBRA deadline extensions?

You will continue to have until one year after your original COBRA deadline to elect COBRA and to pay each of the corresponding premiums.  However, if you want your coverage to be free during the period from April 1 through September 30, 2021, you will need to make sure that you enroll during the 60-day period after you are notified of your ARPA Subsidized COBRA rights (either through a General Notice or a Notice of Extended COBRA Election Period, as applicable).

 


 

Can I change the particular coverage option in which I am enrolled under COBRA?

MIT has decided to allow anyone who is eligible for ARPA Subsidized COBRA (as described above) to also make changes to their COBRA coverage level.  You can choose to change your coverage to another MIT medical coverage option offered by your Participating Employer if it has an equal or lower premium.

 


 

Are Participating Employers in MIT Responsible for Covering Their Former Employees’ Subsidized COBRA?

The procedure to claim this payroll tax credit is expected to be similar to the method you may have used to claim payroll tax credits under the Families First Coronavirus Response Act (FFCRA).  If the tax credit exceeds the payroll taxes owed with respect to that particular quarter, the excess is refundable.  The IRS will publish a procedure that can be followed by you to claim an advance on these credits.