01/24/2025
📣 Recent Developments that Impact Employer-Sponsored Group Health Plans!
Though we are only a little more than halfway through January, there have already been several notable developments within the employee benefits compliance domain. Outlined below are two updates that we want to ensure don’t slip past employers during this busy time of year.
📍 Expiration of Telehealth Relief for High Deductible Health Plans:
When the Coronavirus Aid, Relief, and Economic Security Act (CARES Act) was signed into law in 2020, one of its provisions was to allow qualified high deductible health plans (HDHPs) to provide telehealth services with little or no cost-sharing without requiring participants to satisfy their deductible, and without jeopardizing participant eligibility to contribute to a health savings account (HSA). The Consolidated Appropriations Act, 2023 extended this relief through December 31, 2024.
Many anticipated that The American Relief Act, 2025 would further extend this relief for employer-sponsored group health plans, but it was ultimately absent from the final version of the law. This means that once a group’s plan renews in 2025, providing cost-sharing for telehealth services at less than fair market value before a participant’s deductible is satisfied will disqualify the participant from HSA eligibility, unless the telehealth service is for preventive care. Employers with non-calendar year plan years can continue to take advantage of the telehealth relief for a bit longer, until their plan’s 2025 renewal, while employers with calendar-year no longer qualify for the relief.
For employers that want to maintain HSA-eligibility for participants of their 2025 HDHP offering, we encourage those impacted by the expiration of this relief to (1) charge fair market value for telehealth (at least until the minimum HDHP deductible is met), (2) amend their plan documents to reflect any changes in cost-sharing, and (3) determine how they want to communicate those changes to employees (e.g., by distributing summaries of material modification).
📍 Hospital Indemnity Notices No Longer Required:
In the spring of 2024, the Departments of Health and Human Services, Labor, and the Treasury issued final rules governing employer-sponsored indemnity insurance. One requirement within these rules was a mandate that, for plan years beginning on or after January 1, 2025, any employer offering indemnity insurance include a prescribed notice spelling out the differences between fixed indemnity coverage and comprehensive coverage within any marketing, application, and enrollment materials that they provide to participants.
Several insurance companies challenged this requirement as not being authorized by law, and a district court judge agreed with those companies and struck down the new notice requirement at the end of 2024. Though an appeals process is possible, for now, employers that offer indemnity insurance do not need to provide these notices.
