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Enrollment for 2021 plans starts on November 1

Questions about our plans? Call us at 844-655-0355, Monday – Friday 8 am to 6 pm.

The COVID-19 National Emergency and Public Health Emergency Set to End

In early 2020, a Public Health Emergency (PHE) and then a national emergency was declared to help our nation respond to the global pandemic.

The COVID-19 national emergency will end May 11, 2023, but it includes an additional 60-day period to extend deadlines for COBRA elections and payments, HIPAA special enrollment, appeals, and member submitted claims. These deadlines will return to normal timeframes starting July 11, 2023.

The COVID-19 PHE will end May 11, 2023, removing the federally mandated coverage requirements for COVID-19 testing, related services, treatments, and vaccinations.

Here’s a summary of the changes that begin May 12, 2023:

BenefitStarting May 12, 2023
COVID-19 Lab Test & Related ServicesDiagnostic (FDA approved) COVID-19 lab tests that are medically necessary and ordered by a health care provider (including testing-related services) will be covered in accordance with the terms of the member’s health benefit certificate.
Over-the-Counter (OTC)
COVID-19 Home Tests
No coverage for OTC COVID-19 home tests. Members may use their Health Savings Accounts (HSA) and Flexible Spending Accounts (FSA) to purchase OTC tests.
COVID-19 Antiviral
Medications (i.e., Paxlovid and Lagevrio)
$0 member cost share for these prescriptions while the government supply is available.
Once the government supply depletes, these prescriptions will be covered in accordance with the terms of the member’s health benefit plan.*

*Plans that carve out pharmacy benefits to a third-party administrator will need to consult the pharmacy benefit manager.
Telehealth (Medical and Behavioral)Telehealth visits will be covered in accordance with the terms of the member’s health benefit plan.
COVID-19 Vaccines & Boosters$0 member cost share for COVID-19 vaccines and boosters while the government supply is available. Once the government supply depletes, COVID-19 vaccines and boosters will be covered in accordance with the terms of the preventive benefits in the member’s health benefit plan.

More information can be found on the U.S. Department of Health & Human Services website.

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