Late last year, the Consolidated Appropriations Act, 2023 (CAA 2023) was signed into law. Much of the discussion about this massive “omnibus” spending package has centered on the Setting Every Community Up for Retirement Enhancement 2.0 Act, a law within the package that addresses qualified retirement plans. However, the CAA 2023 also brings changes to group health plans. Here are some highlights of those provisions.
Telehealth and HDHPs
Tax-advantaged contributions generally cannot be made to a Health Savings Account (HSA) unless the account holder is covered by a high-deductible health plan (HDHP) and doesn’t have disqualifying non-HDHP coverage. Congress created exceptions to these rules to facilitate the use of telehealth during the onset of the pandemic, but the exceptions applied only to plan years beginning on or before December 31, 2021, and for the last nine months of 2022 without regard to plan year.
The CAA 2023 extends the exceptions by providing that telehealth and other remote care services will be considered “disregarded coverage” and, thus, won’t cause a loss of HSA eligibility during plan years beginning after December 31, 2022, and before January 1, 2025. In addition, HDHPs may provide coverage for telehealth and other remote care services during those plan years before the minimum deductible is satisfied without losing their HDHP status.
Apparently, non–calendar-year HDHPs will have a gap between the end of 2022 and the beginning of the 2023 plan year during which the relief doesn’t apply. However, individuals covered under these plans may be able to use the full contribution rule (sometimes referred to as the “last month” or “no proration” rule), which allows a full year’s worth of HSA contributions to be made by someone who’s HSA-eligible for only part of the year.
Mental health parity
The CAA 2023 provides funding to assist states in their enforcement of the CAA 2021 requirement that health plans and insurers prepare comparative analyses of any nonquantitative treatment limitations on mental health or substance use disorder coverage.
It also eliminates the right of self-insured non–federal-government health plans to opt out of compliance with the Mental Health Parity and Addiction Equity Act (MHPAEA). Effective immediately, no such new elections may be made, and elections expiring 180 days or more after December 29, 2022, may not be renewed. Provisions that would have imposed civil monetary penalties for violations of the MHPAEA didn’t make it into the final bill but may resurface in future legislation.
More developments ahead
Employers that sponsor group health plans should take note of these provisions and be on the lookout for further developments in 2023.
© 2023
