ASCEND TO WHOLENESS HEALTHCARE PLAN
North American Division Healthcare Assistance Plan
Notice Related to the End of the COVID-19 Public Health Emergency
Background
The federal government has announced a May 11, 2023 end to the COVID-19 Public Health Emergency (the “PHE”).* During the PHE, the Plan was required to cover certain COVID-19 related services without cost-sharing and to allow members additional time relating to certain enrollment events and claims and appeals. With the PHE ending, there will be some changes to the Plan as shown in the chart below.
Plan Changes
Plan Feature
Description of Current Feature and Change
Date of Change
Member cost share for COVID-19 related items
During the PHE, the Plan waived member deductibles, copayments, and coinsurance for COVID-19 testing and vaccination. Except as provided below, beginning May 12, 2023, COVID-19 related services will have member costsharing applied like any other type of service.
May 12, 2023
COVID-19 vaccines
During the PHE, the Plan paid 100% of the cost of COVID-19 vaccines regardless of the provider’s network status. Beginning May 12, 2023, the Plan will pay 100% of the cost of a COVID-19 vaccines as a Covered Preventative Service but only when the vaccine is administered by an in-network provider or pharmacy.
May 12, 2023
At-home COVID-19 tests
The Plan will continue to cover the cost of 8 at-home COVID19 tests per month through the end of 2023. Beginning in 2024, the Plan will no longer cover at-home COVID-19 tests.
January 1, 2024
COVID-19 tests administered by a health care provider
During the PHE, the Plan paid 100% of the cost of COVID-19 tests administered by a health care provider. Beginning May 12, 2023, member cost share for provider-administered COVID-19 tests will be in accordance with the Plan provisions for diagnostic testing.
May 12, 2023
Enrollment (HIPAA special enrollment)
During the PHE, members with a special enrollment event had an extra year to make enrollment changes. Beginning July 11, 2023, the Plan will return to the normal (30-day) deadline for changing enrollment because of a special enrollment event.
July 11, 2023
Deadlines for claims, appeals, and independent external reviews
During the PHE, plan members had an extra year to file a claim or an appeal, or request an independent external review. Beginning May 12, 2023, the Plan will return to the normal deadline for these items – 12 months for claims and 180 days for appeals and independent external review requests.
July 11, 2023
If you have any questions, please call Member Services at 888-276-4732.