The Employee Benefits Administration, an arm of the U.S. Department of Labor, on February 4 issued new guidance about the requirement for health plans to cover the cost of certain COVID test kits. The requirement is part of the Affordable Care Act as supplemented by federal COVID-related laws.
Employer health plans (including self-insured plans) and health insurance policies must now cover the cost of over-the-counter (OTC) COVID test kits. These are kits designed for self-administration in which the user self-collects the sample and self-reads the result, without the involvement of a laboratory or health care provider. Tests which are sent to a lab for processing and interpreting are not covered by this rule. There is a limit of 8 tests per month.
The guidance is in the form of FAQ’s and can be found at the DOL website link https://www.dol.gov/agencies/ebsa/about-ebsa/our-activities/resource-center/faqs/aca-part-52. The FAQ’s also discuss how HSA’s are impacted with this requirement, and make clear that a person cannot “double-dip” by, for example, paying for the test kit at a pharmacy from the person’s HSA account and then requesting reimbursement from the health plan.
Note that this new requirement does not apply to the 4 free test kits which can now be obtained directly from the federal government through the link COVIDtests.gov - Free at-home COVID-19 tests.
John Falcone and Luke Malloy handle employment law matters at PLDR Law. Feel free to contact us if you have questions about this matter.