United States Office of Personnel Management

The Federal Government’s Human Resources Agency

Benefits Administration Letter

Number: 23-201 Date: April 21, 2023 

Subject: COVID-19 Public Health Emergency 

Transition

On January 30, 2023, the Biden-Harris Administration announced that the 

Department of Health and Human Services (HHS) intends to end the public 

health emergency (PHE) for coronavirus disease-2019 (COVID-19) on May 

11, 2023.1 

FEHB Carriers must continue to cover benefits for the diagnosis, prevention, 

and treatment for COVID-19 even after the expiration of the PHE. This BAL 

highlights details from FEHB Carrier Letter 2023-08, which may be helpful to 

you in answering questions from employees.

After the PHE expires FEHB Carriers: 

• Must continue to cover laboratory and over-the-counter (OTC) COVID19 diagnostic tests including associated items and services for 

furnishing those tests. Carriers may impose, but are encouraged to 

waive, cost-sharing (including deductibles, copayments, and 

coinsurance) and medical management (including prior authorization)

for COVID-19 diagnostic tests and associated items and services 

furnished after the end of the PHE. 

1 See Executive Office of the President, Office of Management and Budget, Statement of 

Administration Policy: H.R. 382 and H.J. Res. 7 (Jan. 30, 2023). See also HHS Fact Sheet: 

COVID-19 Public Health Emergency Transition Roadmap (Feb. 9, 2023), clarifying that the 

COVID-19 PHE is anticipated to end at the end of the day on May 11, 2023. 
Benefits Administration Letter 23-201

2 

• Are encouraged to provide notice to covered individuals about changes 

to key information about their COVID-19 benefits (e.g., date when the 

Carrier would begin to impose cost-sharing requirements). 

• Must continue to cover, without cost-sharing, COVID-19 vaccines

(including their administration), and any other qualifying coronavirus 

preventive services intended to prevent or mitigate COVID-19 on an 

in-network basis. 

Please see this HHS Fact Sheet which offers a COVID-19 public health 

emergency roadmap that you may share with employees. If employees have 

questions on specific FEHB plans’ coverage and reimbursement, please direct 

them to contact their FEHB plan for more information.

Medicaid and Children’s Health Insurance Program (CHIP) Coverage

Between March 18, 2020 and March 31, 2023, the Centers for Medicare & 

Medicaid Services (CMS) temporarily waived certain Medicaid and Children’s 

Health Insurance Program (CHIP) requirements on the condition that 

individuals were kept continuously enrolled (referred to as the “continuous 

enrollment condition”). The easing of these rules helped prevent people 

with Medicaid and CHIP – in all 50 states, the District of Columbia, and the 

five U.S. territories – from losing their health coverage during the pandemic. 

However, states have begun resuming or will soon resume Medicaid and 

CHIP eligibility reviews following the end of the continuous enrollment 

condition on March 31, 2023. According to some estimates, when states 

resume these reviews, up to 15 million people could lose their current 

Medicaid or CHIP coverage through a process called “unwinding.”2

In an effort to minimize the number of people that lose access to health 

coverage as a result of unwinding, the Biden-Harris Administration is 

working to inform people about renewing their coverage and exploring other 

available health insurance options if they no longer qualify for Medicaid or 

CHIP. 

For purposes of the FEHB Program, pursuant to 5 CFR 892.101, the loss of 

Medicaid or CHIP coverage would be a qualifying life event (QLE) for 

2 For more information about unwinding, see www.Medicaid.gov/unwinding.
Benefits Administration Letter 23-201

3 

employees or eligible family members, and an FEHB enrollment change is 

permitted within 60 days after loss of coverage. In addition, an employee or 

eligible family member becoming eligible for premium assistance under 

Medicaid or CHIP is also a QLE, and an FEHB enrollment change is permitted 

within 60 days after the date the employee or family member is determined 

to be eligible for assistance. 

Agencies are encouraged to ensure that their benefits staff are aware of the 

resumption of Medicaid and CHIP eligibility determinations. Agencies can 

also encourage their employees who are enrolled in Medicaid or CHIP 

coverage to update their contact information with the state Medicaid or CHIP 

agency. Agencies may also encourage employees to respond promptly to 

any communication from the state. OPM’s guidance is based on Question 7 

of the Frequently Asked Questions (FAQs) Part 58 issued on March 29, 2023 

by the Departments of Labor (DOL), Health and Human Services (HHS), and 

the Treasury.

For questions concerning this Benefits Administration Letter, please contact 

your Agency’s Headquarters Benefits Officer. If you do not know who this 

person is, please refer to OPM’s list of agencies and their Headquarters 

Benefits Officers. 

Sincerely,

Laurie Bodenheimer

Associate Director 

Healthcare and Insurance