The CARES Act of 2020 created a temporary safe harbor that permitted Health Savings Account (HSA) -compatible High Deductible Health plans (“HDHP”) to cover telehealth and remote care services on a first-dollar basis, or prior to members satisfying their HDHP deductible. This temporary relief allowed HDHPs to offer telehealth and other remote care services without violating IRS “first-dollar rules,” which require HSA participants to satisfy their deductible before receiving most non-preventive services coverage.
This relief is scheduled to end on December 31, 2021 and will not be available to plan years that start on January 1, 2022 or later. While legislation has been introduced in Congress to further extend this relief or make it permanent, those bills have not become law yet.
Employers that took advantage of this relief for 2020 and 2021 should now plan to charge a fair market value fee for telehealth or other remote care services for participants to retain HSA eligibility, starting with the first plan year that begins on or after January 1, 2022. This fair market value fee should be applied toward the plan deductible and out-of-pocket maximums for 2022 plan years.
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