How insurance carriers are handling Coronavirus

How insurance carriers are handling Coronavirus

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4/2/2020:

UHC Extends COVID-19 Special Open Enrollment

7:19 P.M. – UnitedHealthcare has extended the COVID-19 Special Enrollment Period (SEP) to April 13, and employers with multiple plan options also can buy down to a leaner plan. Options include:
1. Add a special open enrollment for members who previously waived coverage, including dependents, to provide additional access to care. Employers can do this without introducing any new plans from March 23 – April 13 (extended from April 6). Employers will continue to contribute to the cost of the coverage, and coverage will be effective April 1st.
2. Buydown to a leaner plan: Employers with a single-benefit offering that wish to buy down to a leaner plan may do so between now and May 31. They also can re-enroll their population to the leaner plan design. Employers with multi-option plan designs can temporarily buy down to a leaner plan. If employers decide to conduct a SEP when adding the plan, new enrollees who previously waived coverage can select from any of the plans offered by the employer-provided they are eligible and the employer contributes to the cost of coverage. Existing members can also move to the lean plan design, but no other benefit changes are permitted.
3. Add a lean plan design but no SEP: Consistent with the buy-down approach, employers will have until May 31 to add a lean benefit. In that instance, existing members can move to the new lean plan design. No other benefit changes are permitted. New enrollees previously waiving coverage are excluded beyond the April 13 cutoff for SEP.

4/1/2020:

DCHL Drops Group Participation Requirements

10:30 A.M. – DC Health Link is extending the January Small Business marketplace Employer open enrollment eligibility rules for employers seeking to newly offer coverage for all of the 2020 calendar year. This means small businesses can start offering coverage, even if they can’t meet minimum contribution and participation requirements.

3/31/2020:

KELLY Introduces Carrier Payment Extension Guidelines

1:52 P.M. – KELLY & Associates, one of our largest benefit administrators, in an effort to facilitate the process for groups to request an extension for their carrier premiums in light of COVID-19, released a guide today. If you are having difficulties paying your insurance premiums due to the pandemic, reach out to us and we will lead you through the process outlined.

3/30/2020:

FSA/DCA/HSA/HRA Updates Continue to Develop

5:00 P.M. – As needs change due to this pandemic, so do the requirements of our carriers. Clarity Benefits Solutions, for example, introduced the following amendments:

Ability to Change Elections for Dependent Care Flexible Spending Accounts (DCA) and Flexible Spending Accounts (FSA)
The COVID situation provides several possible reasons to allow an election change to a Clarity DCA. For example, the IRS allows an election change for:
• Reductions in hours
• Change in employment status
• FMLA leave
• Substantial change in employer benefits/cost
• Change of cost from the provider
• Change of provider resulting in change of cost

Health Reimbursement Arrangement (HRA) Updates
If an employee is laid off or terminated and their HRA is terminated, they can still submit claims for expenses up to the termination date of the HRA, and they have until the claim’s submission deadline (set by you, the employer) to submit them. If they go on COBRA for insurance, their HRA will continue with it.

Coming Soon: Emergency Funds Account
Clarity is working hard on an offering that, in accordance with Section 139, may allow tax-free contributions to employees and employer tax deduction. This would enable employers to offer targeted financial support for employees in the form of a convenient, pre-funded debit card.

Unlike cash or gift cards, employers could control how the dollars can be spent, preserve unspent dollars and gain access to real-time insights into employee spending trends – with a turnkey program that doesn’t add work for already-stretched internal resources.

We will provide more information on this program in the coming days and weeks.

3/27/2020:

Over-the-counter Drugs and Medicines Eligible for FSAs/HSAs/HRAs Without Prescription

5:00 P.M. – “The CARES Act, a landmark stimulus law passed by Congress today, includes a provision that will benefit participants in Health Flexible Spending Accounts (“FSAs”), Health Savings Account (“HSA”) bank accounts, and certain Health Reimbursement Arrangements (“HRAs”). The CARES Act repeals a rule from the 2010 Affordable Care Act that disallowed tax-free reimbursement of over-the-counter drugs or medicines (collectively “OTC”) without a prescription. This was an unpopular change that removed a tax break for employees beginning in 2011.” Read more here. 

CareFirst Extending Flexible Financial Options

8:00 A.M. – To reduce financial impact and ensure continuity of care during this crisis, customers can request to defer up to two months of premium with no interest or penalty. The deferred premium would be satisfied over time through scheduled periodic payments. CareFirst will also be relaxing requirements around eligibility and waiting periods. Read the full press release.

3/26/2020:

Dept. of Labor now requires notice posters for Families First Coronavirus Response Act

7:00 A.M. – The U.S. Department of Labor provided employers with the required notice to post. Click here to read more about it.

See our post on Facebook with the poster.

3/25/2020:

EMPLOYERS Adds Coronavirus Response to Website

8:00 A.M. – EMPLOYERS, a workers compensation policy provider, added a COVID-19 FAQ and information section to their website. Insurers are taking proactive steps to ensure preparedness for the long-run effects of the pandemic. See the page here.

3/24/2020:

D.C. Health Link Offering Special Enrollment Period

12:04 P.M. – As part of DC Health Link’s response to the Coronavirus outbreak, they are offering a special enrollment period to allow those who are uninsured to enroll in private health insurance now. Read more here.

3/23/2020:

Gov. Hogan Deems Insurance Companies Essential

11:00 A.M. – Maryland Gov. Larry Hogan issued an executive order Monday morning ordering all non-essential businesses to close. In defining what is essential, insurance companies (and agencies) were included. Click here for the full executive order.

3/22/2020:

The Hartford Announces New CoronaVirus Response

12:00 P.M. – The Hartford continues to update its response to the pandemic. The two most recent provisions were:

  • Revised cancellation grace period: To support our Group Benefits policyholders during the challenging days ahead, until June 1st 2020, we will temporarily suspend policy cancellations due to non-payment of premiums for payments due for February, March and April 2020. Please contact your account representative for more information.
  • New Legislation: On March 18th, the Families First Coronavirus Response Act and New York’s Emergency Paid Sick Leave Order were signed into law. The Hartford will begin administering the leave component of the new FMLA provisions as the law takes effect on April 2, 2020. The New York law was effective immediately and we have begun to administer the emergency DBL and PFL components of this new law for our New York state customers.

3/20/2020:

DCHL Suggesting Email in Lieu of Calls

10:00 A.M. – Due to a high influx of calls from the COVID-19 outbreak, D.C. Healthlink is suggesting email communication to get through to them. They also have a dedicated Coronavirus page with carrier information for your convenience.

3/19/2020:

U.S. life insurers impose waiting periods

7:00 A.M. – U.S. life insurers have introduced new waiting periods for those who recently traveled to regions impacted by COVID-19. Read here for more information.

3/18/2020:

Senate Passes COVID-19 Response Bill

5:00 P.M. – H.R. 6201, the Families First Coronavirus Response Act, was passed by the senate after the house approved it two days ago. The bill will provide financial assistance for those affected by COVID-19 and make testing free nationally. Read the full article here.

3/17/2020:

The Hartford Releases COVID-19 Guide

1:00 P.M. – The Hartford, who administers personal, commercial, and group health lines of business, created a COVID-19 guide for client use. It includes information about disability, FMLA, and more. Click here for it.

Medicare Expands Telemedicine

11:40 A.M. – Medicare will provide greater access to telemedicine so more people can focus on self-quarantining. Click here to read a U.S.News article about the expansion.

3/16/2020:

Clarity Suspends Substantiation Requirements for FSAs and HRAs

5:30 P.M. – Clarity Benefit Solutions, an FSA and HRA carrier, will temporarily waive the need for substantiation required by the IRS for these accounts. A statement from the company said:

“During this COVID-19 outbreak, we know your employees might need to use their Clarity Benefits Card for COVID-19 related expenses, as well as for the ordinary medical expenses for which they typically use their health FSA and HRA benefits. Although many expenses that plan participants purchase with the Clarity Benefits Card are auto-substantiated, some are not. To ensure your employees can continue to use their Clarity Benefits Card throughout this crisis, we have decided to temporarily suspend debit card receipt substantiation and debit card deactivation. This means we are freezing our practice of requesting the documentation needed to substantiate debit card transactions and ceasing the deactivation of debit cards when participants fail to submit such documentation for most card purchases.”

Although the IRS requires card suspension if there is not timely substantiation, there is no time limit specified. Clarity believes since this is a temporary protocol, it will not lead to card declination.

UHC Expands Access to Remote Mental Health Services

12:40 P.M. – Optum (a part of United Healthcare) is taking action to ensure health plan members affected by COVID-19  have the support and resources they need.  In order to make it easier for members to continue to receive appropriate behavioral health treatment and support through their employee assistance program during this time, they are encouraging providers and members to use secure video-enabled virtual visits. Optum is supplying the platform that providers need to have secure video visits with members who cannot travel to an office. Learn more here.

Maryland Gov. Larry Hogan Opens Closed Hospitals

11:14 A.M. – During a press conference Monday morning, Gov. Hogan announced a series of “unprecedented” actions, including ordering health officials to open closed hospitals across the state to increase the state’s capacity by 6,000 beds to meet demand. Click here for a complete summary of the announcement.

3/15/2020:

Teladoc Prepares For Influx of Patients Seeking COVID-19 Guidance

9:00 A.M. – Teladoc’s chief medical officer released a statement, reading, “As the COVID-19 outbreak unfolds, our commitment to providing high-quality care has never been more important. Virtual care is recommended by the CDC as the way to get care and help avoid exposure and spread of potentially contagious viruses. In these unpredictable times, our doctors are here for you 24/7 – working tirelessly – to assure that your questions are answered, and needs are resolved. We appreciate your patience during this time.”

Teladoc’s turnaround time is usually around 20 minutes, but due to the current outbreak, it is around one day. If you are planning to seek telemedical care, please be prepared for a bit of a delay. Click here for Teladoc’s website with more information.

3/14/2020:

Travel Insurer IMG Looks at Insurance Options

1:00 P.M. – IMG is looking into extending travel insurance options due to COVID-19. Many trips are getting canceled or rescheduled and they are looking for ways to mitigate costs. We will continue to update you as we hear news, click here for their dedicated COVID-19 page.

3/13/2020:

Maryland Health Connection Opens Emergency Special Enrollment Period for Uninsured Marylanders

3:42 P.M. – In an effort to prioritize health and safety and in response to Coronavirus, Maryland Health Connection opened an emergency special enrollment period for uninsured Marylanders. You can enroll in a health plan starting Monday, March 16, through Wednesday, April 15, 2020. Coverage will begin April 1, 2020, regardless of when a health plan is selected during that time period.

Visit MarylandHealthConnection.gov or download the free “Enroll MHC” mobile app. When enrolling, consumers should request or select “Coronavirus Emergency Special Enrollment Period.” The online application is available daily from 6 a.m. to 11 p.m.

The Centers for Medicare & Medicaid Services Release FAQs For COVID-19 

2:05 P.M. – The Centers for Medicare & Medicaid Services (CMS) posted Frequently Asked Questions (FAQs) on Essential Health Benefits Coverage in response to the 2019 Novel Coronavirus (COVID-19) outbreak. This action is part of the broader, ongoing effort by the White House Coronavirus Task Force to ensure that all Americans – particularly those at high risk of complications from the COVID-19 virus – have access to the health benefits that can help keep them healthy while helping to contain the spread of this disease. The FAQs are shared to ensure individuals, issuers and states have clear information on coverage benefits for COVID-19, detailing existing federal rules governing health coverage that apply to diagnosis and treatment of COVID-19. Click here to read the FAQ. 

Commercial Carriers Consider Endorsements to Cover Business Interruptions From COVID-19

11:50 A.M. – There are a lot of discussions going on as to whether commercial policies would pay claims if a business is interrupted due to the virus. While Government agencies are pushing to have it covered, insurance companies, at this point, are likely to consider it an excluded claim and are looking at endorsements. We will keep you updated as we hear more details.

Travelers to Suspend Issuance of Event Insurance in Light of COVID-19

11:27 A.M – Travelers Personal Insurance Binding Authority (the ability to write/issue policies) is suspended countrywide for Wedding & Event Insurance and the Experience Insurance portion of Traverse.
Binding authority is suspended countrywide for:

  • Wedding & Event Insurance
  • The Experience Insurance portion of Traverse

This suspension applies to new business, requests to reinstate canceled policies and policy changes that request additional coverage or requests to lower deductibles.

Short-Term Medical Provider IHC Group Will Pay Claims Related to COVID-19

10:18 A.M. – In an effort to provide protection and peace of mind to our insureds during the COVID-19 outbreak IHC Group will, effective immediately, waive certain cost-sharing provisions on Independence American Insurance Company’s (IAIC) Short-Term Medical plans (STM) in order to remove financial barriers to COVID-19 testing.

As a part of this effort, all IAIC STM plans will:

  • Waive all insured cost-sharing, including deductibles, copays, and coinsurance, for:
    -The COVID-19 diagnostic test; and
    -The COVID-19 diagnostic related services, including the related office, emergency or urgent care visit.
  • Waive any preauthorization requirements related to COVID-19 testing

3/12/2020:

Loom cuts cost to increase access to remote communication

1:30 P.M. – In light of the increased need for virtual meeting, through July of this year, Loom, the program we use to record all of our insurance proposals, is:

  1. Removing recording limits on our free plan — 25 is now unlimited
  2. Cutting the price of Loom Pro in half — $10/month is now $5/month
  3. Extending all trials of Loom Pro from 14 to 30 days
  4. Making Loom Pro free for teachers and students at K-12 schools, universities, or educational institutions

Click here for their official statement

Long Term Care Providers Advised to Act to Protect Residents from COVID-19

1:00 P.M. – In an effort to assist long term care providers, the Centers for Disease Control, the American Health Care Association (“AHCA”), and the National Centers for Assisted Living (“NCAL”) have published guidance on efforts that long term care providers should take to protect residents from COVID-19.
The AHCA and NCAL guidance issued to long term care providers as of March 9, 2020, includes the following five elements:

  1. Restrict entry to only individuals who need entry. This safety precaution would limit entry to employees and staff needed to maintain operations and meet the needs of the residents; government officials who require entry in their official capacity; or immediate family or friends who need to visit for critical or time-sensitive reasons.
  2. Restrict activities and individuals with potential for exposure. Specifically, the guidance advises that facilities restrict visitors when there are confirmed cases of COVID-19 in the surrounding community; cancel activities that take residents into public places; restrict internal group activities especially if the Facility has residents with respiratory symptoms or if COVID-19 has been diagnosed in the surrounding community.
  3. Actively screen all individuals entering the building. It is recommended that facilities screen all individuals who enter the building. This recommended screening would include checking for respiratory symptoms (fever, sore throat, cough, or shortness of breath); screening for international travel within the last fourteen (14) days to areas where there are confirmed cases of COVID-19; determining whether the potential visitor has worked in another health care setting with confirmed COVID-19 cases.
  4. Require all visitors to wash their hands prior to entry. To the extent possible, it is recommended that long term care facilities set up hand-washing stations, or otherwise make alcohol-based hand rub stations available upon entry. Visitors also should be reminded to practice social distancing while in the Facility, including avoiding handshakes or hugs.
  5. Establish processes to allow remote communication for residents and others. Given the recommended restrictions on visitors, it is critically important to the overall well-being of residents that they are otherwise able to readily communicate with family and friends through alternative means. Alternative methods could include ensuring that video chat technology is available, that they have access to cell phones for calls and texting, or that they have access to other forms of social media.

Click here for more information

HDHPs Will Cover Expenses Related to COVID-19

10:30 A.M. – In light of the current pandemic, the IRS has provided the following notice as guidance to the public. IRS Notice 2020-15 was posted yesterday, March 11th providing clarification that High Deductible Health Plans (HDHPs) will cover 2019 Novel Coronavirus (COVID-19) related testing and treatment before plan deductibles have been met. This also means HSA participants can continue to contribute to their HSA if enrolled in an HDHP. Having the testing and treatment covered before the plan deductible has been met will not jeopardize their eligibility. The notice also explained any vaccination costs would continue to count as preventative care and will be paid for by an HDHP.

Click here for the full notice

Statements from Insurance Carriers Regarding Testing Costs

As a resource to you, we have compiled statements regarding how insurance carriers are handling Coronavirus (COVID-19) below.  Always follow CDC guidelines and please feel free to reach out to us for any additional guidance!

Kaiser Permanente- As a member of Kaiser Permanente, you will not have to pay for costs related to COVID-19 screening or testing. Kaiser Permanente will not charge member cost-sharing for all medically necessary screening and testing for COVID-19. This policy applies to the cost of the visit, associated lab tests, and radiology services at our hospital, emergency department, urgent care, and provider offices where the purpose of the visit is screening and/or testing for COVID-19. Click here for the full notice.

CareFirst- Effective March 6, 2020:
• Will cover medically necessary diagnostic tests that are consistent with CDC guidance related to COVID-19 without member cost-share.
• Eliminated prior authorization requirements for diagnostic tests and covered services medically necessary and consistent with CDC guidance for members diagnosed with COVID-19.
• CareFirst is waiving early medication refill limits on 30-day maintenance medications. Member cost-sharing will apply as normal.

United Healthcare- UHC will waive member cost-sharing for COVID-19 diagnostic testing provided at approved locations. Click here for the full notice. They are also offering professional mental health counseling for those dealing with the impacts of the pandemic.

Aetna- Aetna will waive co-pays for all diagnostic testing related to COVID-19. This policy will cover the cost of physician-ordered testing for patients who meet CDC guidelines. Also, Aetna will waive the member costs associated with diagnostic testing. Lastly, due to their partnership with CVS, members will also have access to the following resources:

  • For the next 90 days, Aetna will offer zero co-pay telemedicine visits – for any reason. Aetna members should use telemedicine as their first line of defense in order to limit potential exposure in physician offices.
  • Through Aetna’s Healing Better program, members who are diagnosed with COVID-19 will receive a care package containing CVS over-the-counter medications.
  • Aetna is extending its Medicare Advantage virtual evaluation and monitoring visit benefit to all Aetna Commercial members as a fully-covered benefit.

Click here for the full notice

Anthem- will cover the cost of coronavirus testing with no out-of-pocket cost. Anthem also confirms that prior authorization is not required for diagnostic services related to COVID-19 testing. The company recommends using telehealth when possible to help prevent the spread of a virus. It is also encouraging its members to talk to their doctor about whether it is appropriate for them to change from a 30-day supply of their regular medications to a 90-day supply.

Click here for the full notice

Additionally, the state of Maryland waived testing fees and enacted other emergency measures to reduce cost-sharing for COVID-19.

Lincoln Financial- “If an employee is affected by the COVID-19 situation, such as being quarantined, having been temporarily laid off or furloughed, on leave to take care of children or having reduced hours below policy requirements (whether no longer being paid, receiving wages, or continuing to be paid), we will still consider this employee actively at work and therefore eligible for Lincoln Financial coverages. Our intent is to cover all employees who would have been eligible for coverage had business not been interrupted by the COVID-19 situation. This includes newly hired/enrolled employees and those whose coverage LFG is taking over from a prior carrier. Our stance is that as long as premium is paid, employees can maintain coverage as though they are at work through May 1, 2020, or in accordance with the Continuation provisions in their policy if they are more generous. If an employee’s coverage terminates due to other reasons, such as employment termination or non-payment of premium, then the policyholder should review their conversion, portability and/or COBRA options in their policies.” Premium Payment Grace Period- “In order to provide employers and their employees greater flexibility in making required premium payments, we are extending the standard grace period on Lincoln-issued group insurance policies and service agreements to 60 days. This update goes into effect retroactively to March 1, 2020.We will continue to monitor the COVID-19 situation and will reassess our position by May 1, 2020. Additionally, Lincoln will comply with any state-issued mandates and update our practices accordingly.”

Travelers- Effective immediately, Travelers is suspending cancellation and nonrenewal of coverage due to nonpayment through May 15, 2020. There will be no late fees, interest, or penalties, just extra time for policyholders to pay their premiums due to the financial implications of this pandemic. More info here.

Umum- The voluntary benefits provider has a Coronavirus response and FAQ page they will continue to update.

We hope seeing how our insurance carriers are handling coronavirus provides you with some clarity. We will continue to update you with any new information below.

 

 

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