In accordance with interim final regulations issued in October by the Departments of Labor, Health and Human Services, and Treasury, non-grandfathered group health plans must cover qualifying COVID-19 preventive services, including any vaccine and its administration, without cost sharing, within 15 business days (not including weekends or holidays) of a recommendation from the United States Preventive Services Task Force or ACIP. ^[1]

To date, the FDA has issued EUAs, with the ACIP subsequently issuing interim recommendations, for the Pfizer-BioNTech COVID-19 vaccine (for persons age 16 or older), the Moderna COVID-19 vaccine and the Johnson & Johnson vaccine. ^[2]

Non-grandfathered group health plans are required to cover the Pfizer-BioNTech (for persons age 16 or older), Moderna and Johnson & Johnson COVID-19 vaccines with no cost sharing effective January 5, January 12 and March 19, 2021, respectively. ^[3]

Footnotes

1. “Regulations on COVID-19 vaccine and testing requirements issued,” Insider, November 2020. Return to article undo
2. “Third COVID-19 vaccine added to preventive care guidelines,” Insider, March 2021. Return to article undo
3. “Agencies propose FAQs on nonquantitative treatment under MHPAEA,” Insider (May 2018). Return to article undo