We recently caught up with Nick Karls, director of compliance at Holmes Murphy and Associates, for a wide-ranging conversation on virtual care trends, compliance updates, and the key roles that benefits advisors will play in guiding employers in 2023 and beyond.

How has the Consolidated Appropriations Act (CAA) of 2023 impacted the access enrollees have to virtual health care services?

Nick Karls, Compliance Director, Holmes Murphy

The CARES Act of 2021 and the Consolidated Appropriations Act of 2022 created temporary relief through the end of 2022 in which telemedicine and other virtual health services could be provided to individuals covered by an HDHP on a no-cost or shared-cost basis before their minimum deductible was met and still be HSA contribution-eligible. CAA23 extends this relief for plans starting after December 31, 2022, and before January 1, 2025. The relief continues to cast a broad net and includes "other remote care services," a term that is not defined but could encompass benefits and services not provided in a traditional medical facility. It's important to note that a plan sponsor of an HSA-qualified HDHP is not required to adopt this change for their group health plan and can continue to require plan participants to pay the fair market value of the virtual health benefit option provided until the minimum deductible is met. However, if a plan participant purchases their own virtual health benefit outside of the group health plan, it appears that this will not impact their eligibility to contribute to their HSA. Another issue that should be noted is that there seems to be a conundrum for the sponsors of non-calendar year HDHP plans, as the way the legislation was drafted indicates that non-calendar year plans cannot start to provide no-cost or shared-cost virtual health services until their plan year starts in 2023, leaving a gap at the start of the year. It's possible that agency guidance will address this issue.   Interestingly, it looks like the main impetus for the continued HSA relief was less a response to the pandemic, as it had been in past legislation, and more of a response to the growing need for better access to mental health services. As a result, it's possible that we see some form of permanent change made in the future more tailored to these goals.