The U.S. Department of Labor's Employee Benefits Security Administration (EBSA),
in conjunction with the Internal Revenue Service, have announced a further extension
of a number of deadlines so workers and employers affected by Hurricane Katrina
have additional time to make health-coverage decisions.
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Download NowThe relief provides additional time to comply with certain deadlines, contained
in the Consolidated Omnibus Budget Reconciliation Act (COBRA), the Health Insurance
Portability and Accountability Act (HIPAA), and the rules for processing of
health claims.
For participants, beneficiaries, and plans in the disaster areas, the time frames
for the following provisions are tolled for the period between August 29, 2005
and February 28, 2006. The effect is to freeze the application of the time periods
through February 28, 2006.
Extended Time Frames
- The Health Insurance Portability and Accountability Act (HIPAA) provides
portability of group health coverage by, among other things, giving people
credit for prior health coverage. Under the general HIPAA rules, prior credit
may be disregarded if a person goes without coverage for 63 days. Under the
agencies' relief, this time period has been extended to allow Katrina victims
more time to secure health coverage without losing coverage for preexisting
health conditions.
- HIPAA also requires special enrollment rights upon certain events, such
as loss of other coverage, but only if an individual requests enrollment within
30 days of the loss. Relief has also been provided to allow Katrina victims
more time to request enrollment in other group health coverage.
- The Consolidated Omnibus Budget Reconciliation Act (COBRA) permits qualified
beneficiaries who lose coverage under a group health plan to elect continuation
health coverage. The general COBRA rules allow 60 days to request COBRA coverage.
This time frame has also been extended to give Katrina victims more time to
request continuation coverage.
- The COBRA rules also govern timing of premium payments. A grace period has
been added to give victims more time to make their COBRA payments.
- The benefit claim procedure rules require employee benefit plans to establish
and maintain reasonable procedures for the determination and appeal of benefit
claims. EBSA is requiring plans to extend time frames for affected individuals
to file a benefit claim and to file an appeal.
- Plans must provide certain notices in connection with the HIPAA portability
and COBRA continuation provisions within certain time frames. The agencies
are extending these time frames for plans that cannot make their disclosures
on time due to the hurricane