COVID-19 Information and Updates

Things have been changing very quickly with the coronavirus (COVID-19) situation in the United States.  Fighting the spread of COVID-19 is a top priority right now in our country, and this challenge has changed our normal way of life. We’re facing social and economic uncertainty at home, in our country, and globally. But one thing’s for certain: we’re all in this together. That’s why we’re providing you with these Frequently Asked Questions about COVID-19 FAQs and continuous updates.

As a company with steadfast and strong roots since 1916, Mason-McBride has weathered storms through tumultuous and historical times throughout the decades: wars, the Great Depression, economic uncertainty, 9/11, and now, COVID-19. While we’ve been tested in the past as well as the current day, our spirit remains strong, and we want you to know and to reassure you that we remain here for you.

We understand the impact that flattening the COVID-19 curve has on our clients. We want you to know how much we appreciate your flexibility and understanding as we contact our carriers on your behalf who are working differently in light of the current situation. Response times may be slower than normal, and we completely understand your frustration. But rest assured, we are doing everything we can to be as responsive as possible to your questions, concerns, and needs during this fluid and ever-changing point in our history.

We look forward to returning to the time where we can live our normal way of American life. Until that time, please take care of yourselves, your loved ones, and be kind to others who may need help.

Sincerely yours,
W. Michael McBride
President


Mason-McBride Remains Open

open for business sign

Yes, our office remains open to service and support all of our clients, from Commercial Lines to Personal Lines to Group Benefits.  We are here to answer your questions and concerns.  Please be aware that while we are working with insurance carriers, their workflows and office situations have changed too, and there might be a longer than usual response time.  We understand your frustration, but we are doing everything possible to obtain the information you need as soon as possible.

Rest assured, we are taking all precautions and following guidelines announced by the CDC to keep our staff safe and healthy, including frequent sanitation at designated intervals, social distancing, and requesting that if anyone falls ill, that they remain at home.  Regarding in-person meetings, we’ll follow your lead and your wishes.  Just let us know.
Review MMC’s Executive Order Exception


Health Alliance Plan (HAP) Update, Added 08/26/21

At the start of the pandemic, HAP announced that it would extend its member cost-sharing waivers for the testing, treatment, and telehealth services related to COVID-19 through September 30, 2021, meaning members will not be charged any copays, co-insurance, or deductibles when being tested or receiving care for an acute diagnosis of COVID-19. 

Beginning Oct 1, 2021, coverage for the treatment of COVID will return to the standard benefitHAP will continue to waive member cost-sharing for COVID-19 diagnostic tests and test-related visits and the COVID-19 vaccine for all lines of business during the public health emergency according to state and federal guidelines, in accordance with the CARES Act and the Families First Coronavirus Response Act (FFCRA).


COMMERCIAL LINES ISSUE ALERT — Added May 26, 2020

We have become aware of instances whereby certain indemnification and hold harmless language in contracts are being modified to include exposure for COVID-19 resulting from any property condition or your employees at a location.

We urge clients to carefully review these provisions as counterparties may be modifying them without notice. Accordingly, please seek counsel as needed. It’s important to remember that any agreement you execute that binds you to potential liability does not alter the terms of an insurance policy. There are elements in Hold Harmless and Indemnification language which are insurable and not insurable.


What’s happening with my auto/home/commercial insurance due to COVID-19?

PLEASE NOTE: THE INSURED IS NOT REQUIRED TO DO ANYTHING TO QUALIFY FOR ANY PREMIUM ADJUSTMENTS. The Premium adjustments are subject to regulatory approval. The refunds must be approved by the Department of Insurance and Financial Services before the carriers can distribute.


Allstate/Encompass Insurance

• Most customers will receive 15% of their monthly premium in April 2020 and May 2020: a credit to their bank account, credit card or Allstate account.
• Allstate is making the Allstate Identity Protection product free for the rest of the year with no opt-out-requirement.
• Allstate customers experiencing financial challenges can call Allstate to learn how to delay payments without penalty. The Special Payment Plan gives auto and homeowners insurance customers the choice to delay two consecutive premium payments.
• Allstate is expanding insurance coverage for customers who use their personal vehicles to deliver food, medicine, and other goods for commercial purposes.
• The Allstate Foundation is contributing $5 million to accelerate relief and recovery for domestic violence victims, youth in need, first responders and communities at large.


Auto-Owners

• 15% premium refund to personal automobile policyholders for the months of April and May 2020.


Cincinnati Insurance

• Auto clients will receive a 15% credit per policy on their April 2020 and May 2020 premiums.
• Cincinnati Insurance is pausing cancellations due to nonpayment of premium and waiving late fees until at least April 30, 2020, and waiving restrictions on policyholders now performing delivery services in efforts to protect the wellbeing of their communities.


Frankenmuth Insurance

• Auto clients will receive a 15% premium refund for April 2020 and May 2020.
• Upon regulatory approval, refund checks will be issued for policies in force as of April 30.  Vehicles included are automobiles, vans, and pickup trucks. The refund does not apply to automobiles in storage, antique vehicles, motorhomes, motorcycles, trailers, and campers. Frankenmuth policyholders may also call Frankenmuth’s Personal Lines underwriters team at (800) 234-1133, ext. 3010.


Grange Insurance

• Personal auto policyholders will receive a 25% credit for the months of April 2020 and May 2020. The estimated total credit impact to be up to $25 million throughout the 13 states in which Grange Insurance operates.


The Hartford

July 9, 2020 Update: In addition to any credits already issued for April 2020 and May 2020 monthly premiums, The Hartford will issue an additional credit equal to 15 percent of one month’s worth of auto insurance premium.  To be eligible, the personal auto insurance policy must have been in effect as of June 1, 20202.  Customers do not need to take any action to receive this credit.
• 15% Payback: The Hartford will be issuing a 15 percent refund on two months’ worth (April 2020 and May 2020) of premium for all customers with an in-force personal auto policy as of April 1, 2020. More details about The Hartford’s Personal Auto Payback Plan
• Billing grace period: For customers having financial difficulty, we will waive late-payment fees and cancellations for non-payment. This applies to personal auto and home policies until May 31, 2020.


Liberty Mutual / Safeco Insurance

• Personal auto insurance customers will receive a 15% refund on two months of their auto premium, based on your premium amount as of April 7, 2020.
• Liberty Mutual / Safeco Insurance will waive late fees for any customer unable to make a payment due to COVID-19.


The Main Street America Group

• The Main Street America Group has a special relief program to return $16.5 million in premium to personal auto insureds.
• The company is extending private passenger automobile coverage to food delivery drivers hired by restaurants as well as offering temporary coverage for restaurant insureds performing first-party food delivery service.
• There will be a 20% premium credit for all Business Owner’s and Contractors insureds for the months of April 2020 and May 2020 for policies in force as of March 31, 2020.


Mercury Insurance

• Mercury Insurance has a Private Passenger Automobile Giveback Program — 15% back to Mercury Insurance customers in April 2020 and May 2020.


Nationwide

• Nationwide is offering a one-time premium refund of $50 per policy for personal auto policies active as of March 31, 2020.
• Can suspend the cancellation of some policies, defer payment deadlines and waive some late fees
• Provide coverage for most existing restaurant and retailer exposures who now engage in delivery service.
• Nationwide Foundation made $5 million in contributions to local and national charities to support pandemic response efforts.


Progressive

• Progressive has an Apron Relief Program — Progressive is providing $1 billion to customers, employees, agents, and communities.
• Progressive personal auto customers who have a policy in force as of April 30th will be credited 20% of their April 2020 premiums in May 2020.  Personal auto customers with a policy in force as of May 31, 2020 will be credited 20% of their May premiums in June 2020.
• Progressive is suspending cancellations and non-renewals on personal and commercial lines policies for non-payment through May 15, 2020.
• The company is providing commercial lines customers with a business owner or general liability policy underwritten by Progressive a 20% credit on April 2020 and May 2020 monthly premiums.
• Progressive is providing a full-service claims experience for first responders and health care workers who experience a car accident by providing enhanced roadside service (including transportation to work or home from the accident if needed), expedited tow service and vehicle repairs, pick up and delivery of the repaired vehicle, all while deferring deductibles and providing a rental vehicle if needed.
• Expanding coverage for personal auto customers temporarily delivering food or medicine and allowing commercial customers additional coverage options for delivery.
• Extending payment leniency, waiving late fees, and pausing collections.
• Deferring deductibles to help customers who cannot pay out of pocket costs to get their car repaired.
• Providing delivered meals for its for-hire trucking customers, first responders, and health care providers.


Travelers Insurance

• Stay-at-Home Auto Premium Credit Program: U.S. personal auto insurance customers will receive a 15% credit on their April 2020 and May 2020 premiums.
• Effective immediately (March 27, 2020), we are suspending cancellation and nonrenewal of coverage due to nonpayment through May 15, 2020. We will not charge interest, late fees or penalties during this period, providing policyholders extra time to pay their premiums without risking cancellation.
• Continues to provide auto coverage for customers across the country whose job responsibilities now include using their personal vehicles to make food, grocery, pharmacy, and medical supply deliveries.
• Travelers pledged $5 million to assist families and communities affected by the COVID-19 pandemic across North America, the United Kingdom, and the Republic of Ireland.


COVID-19 Vaccinations

Photo of covid-19 vaccine in glass bottle

All information about getting vaccinated is available on the state of Michigan website. The site has added contacts for local health departments. The website says that a timetable for appointments will depend on vaccine availability from the federal government. People who live outside of Michigan should contact their state’s health department for information on their area’s vaccine distribution plans, which can vary from state to state.


Two Main COVID-19 tests, explained by BCBSM

There is a COVID-19 diagnostic test and a COVID-19 antibody test.
Learn about the differences and the latest updates regarding these tests.

a swab being inserted into a test tube for coronavirus


What’s happening with health insurance carriers and other benefit providers?

Listed in alphabetical order, here’s where you can find the most accurate, current information from various carriers.

a woman holding wooden cutouts of a person and a medical briefcase

Aetna


Extending liberalizations for small group (2-100) — Updated 3/23/2021

Aetna continues to remain committed to you and your clients during these unprecedented times. When COVID-19 escalated in the US, Aetna®, a CVS Health® Company, was among the first in the industry to allow crisis policy changes. As the country and states continue to adjust recovery planning and reopening businesses, know that we will continue the extension of many of these policies through June 30, 2021.

We will continue to keep a close pulse on COVID-19 and adjust our policies as needed to keep all our members healthy.

For more information about COVID-19-related resources and support, please visit our section on Aetna.com for employers and producers, member FAQs page, or contact Mason-McBride.

Aflac


All Savers

Setting up a “Healthiest You” Account

Updated January 13, 2021
Like all of you, we are concerned about the impact that COVID-19 could have on the health and wellbeing of the people we serve.

UnitedHealthcare has a team closely monitoring COVID-19 and, as with any public health issue, we are working with and following all guidance and protocols issued by the U.S. Centers for Disease Control and Prevention (CDC), Centers for Medicare & Medicaid Services (CMS), Food and Drug Administration (FDA), state and local public health departments in supporting our members’ needs.

To help ensure our members have access to care, UnitedHealthcare is waiving member cost-sharing for inpatient treatment through 1/31/21 if care is received at an in-network facility for its fully-insured group market health plans and Medicare Advantage plans. For All Savers customers, we will also cover these expenses, which means they will be paid under your plan and through UnitedHealthcare stop-loss policies.

Thank you for your patience and support as the situation continues to evolve during this challenging time. We will continue to keep you updated as we have additional guidance and guidelines. In the meantime, if you would like to discuss any aspect of this proposal or other steps we are taking related to COVID-19, please contact All Savers Customer Call Center at (866) 405-7174.


Ameritas


Avēsis

In response to current events, we are extending our premium grace periods to groups. Through May 31st, Avēsis clients will be granted an additional 30 days of grace period beyond current policy limits. For example, if your grace period for payment has been 30 days, it will now be extended to 60 days.


Assurant


Basic

Message from BASIC:
Due to the current COVID-19 Pandemic that continues to impact businesses, the Coronavirus Aid, Relief, and Economic Security Act (CARES Act) was signed into law on March 27, 2020 to provide some assistance to employers and employees being directly affected.

We understand that during this time of uncertainty, employers across the nation have been forced to reduce their workforce and have many questions regarding the impact of COVID-19 on COBRA compliance. While we are hopeful that the federal government provides relief impacting COBRA in terms of administration and premium assistance, to date, there have been no legislative changes impacting COBRA. We are closely monitoring legislation and guidance as it is released so that we can keep our clients and participants informed of any changes. We have prepared this FAQ to help with some of the questions that we have been seeing in regard to COBRA continuation during this crisis.

Q: Are there any changes to COBRA continuation in the new CARES Act?
A: At this time, there have been no changes to the regulations for COBRA (including subsidizing premiums, extending coverage periods or extending election or payment grace periods). If a current COBRA participant loses coverage because of failure to make timely payments due to circumstances surrounding COVID-19, they may be able to file an appeal for review by the employer to determine if they will be eligible for reinstatement once payments have been made current.

Q: What distinguishes a furlough from a layoff?
A: The primary difference between a furlough and a layoff is its impact on the employment relationship. During a furlough, active employment status is maintained and the employee has a reasonable expectation to return to work. As a result, unpaid furloughs are typically treated the same as an unpaid leave of absence. In contrast, layoffs typically mean employment and benefits are terminated, resulting in a COBRA event where the employee is not guaranteed rehire.

Q: Are employers mandated to extend COBRA grace periods?
A: Not at this time. Currently, there are no changes to the COBRA regulations regarding grace periods for elections or payments. An employer may allow a COBRA participant additional time to elect or make a payment. However, due to restrictions with the carriers, not all plans may be able to make this exception, and if an extension is allowed for one employee, it should be provided to all employees. It is the responsibility of the employer to confirm with the carriers if they will allow extensions before approving them.

Q: Can participants make partial payments?
A: The recent legal changes have not included changes to the COBRA regulations regarding collection of premium payments within the allotted grace period. However, an employer may allow COBRA participants additional time to make a payment-in-full, which would be an extension of the grace period. The employer will need to notify BASIC of an intended change to the administration of grace periods. Due to restrictions with the carriers, not all plans may be able to make this exception. It is the responsibility of the employer to confirm with the carriers if they will allow extensions before approving them. If an extension is approved, the employer must acknowledge in writing to BASIC that they will not hold BASIC liable for short payments that are not collected from participants and cannot be recouped from the carriers as a result of these extensions. Please contact a BASIC representative for additional information.

Q: Can a participant that has missed their election or payment grace period file an appeal?
A: Yes. A participant is allowed to file an appeal to the Plan Administrator (employer) to request reinstatement. BASIC requires all appeals in writing from the participant, which will then be passed along to the employer for approval or denial. Once a decision has been made, BASIC will notify the participant and process any late elections or payments as approved. It is the responsibility of the employer to confirm with the carriers if they will allow an appeal before approving them.

Q: Can a participant extend their federal COBRA continuation period?
A: Not at this time. There have been no changes in the regulations to allow for additional coverage periods outside of the standard Federal COBRA guidelines. Participants may have other health coverage available to them, including coverage through the Health Insurance Marketplace at www.HealthCare.gov or by calling 1-800-318-2596.

Q: What is the COBRA obligation for an employer that is going out of business?
A: Unfortunately, if an employer is going out of business and health plans will cease to exist, there is no obligation to offer COBRA to employees losing coverage. At this time, we recommend that any employees losing coverage due to a permanent closure refer to the Health Insurance Marketplace at www.HealthCare.gov or call 1-800-318-2596 to find a plan that works for them.


Blue Cross Blue Shield of Michigan/Blue Care Network

BCBSM has produced a Blue Cross COVID-19 Overview Guide.

BCBSM updated their “COVID-19: What You Need to Know” webpage on March 5, 2021.

BCBSM has an online Employer Toolkit, so employers may help their employees find answers to their questions about prevention, coverages, and care.

Update, March 25, 2021: Blue Cross Partnering with FEMA, Meijer, and Henry Ford Health System on Ford Field Vaccination Clinic

Learn more about the Ford Field vaccination clinic and how to register for the COVID vaccine.

Blue Cross offering myStrength well-being tool at no cost to help members

Blue Cross Blue Shield of Michigan continues to offer solutions for people who are experiencing the physical and mental effects of the pandemic.  BCBSM members will have no-cost access to the COVID-19 module for myStrength, an online well-being tool. This myStrength document contains links and instructions to get started.

Blue Cross Blue Shield of Michigan | Blue Care Network to Return More Than $100 million to Insured Customers and Members for Medical, Dental, and Vision Premiums

Full press release and details.

My health insurance is with Blue Cross Blue Shield of Michigan or Blue Care Network. What is this carrier doing in light of the COVID-19 outbreak?

We have been in touch with BCBSM/BCN, and they have informed us of web pages they have posted specifically regarding coronavirus:

Information directly from Blue Cross Blue Shield of Michigan / Blue Care Network: frequently asked questions about coverage, rates, and membership in light of COVID-19 (for Commercial and Medicare Advantage groups)

Question: Will Blue Cross Blue Shield of Michigan and Blue Care Network allow employers to extend coverage to their employees who are affected during temporary closures or are temporarily laid off or have temporarily reduced hours?
Answer: Yes, Blue Cross and BCN will allow extension of coverage for all group sizes provided premiums are paid based on current payment policies. Paying the premium is all that is required; no need to submit additional paperwork for current employees.
The following would apply:
• The employer still considers the individual an employee and therefore eligible for coverage under the group’s plan.
• The employer maintains premium payments.
• The employer should notify the employee that benefits would be maintained for a specified number of months.
• If the employee does not return after the specified period, the group would proceed with the normal loss of coverage/termination process.

Question: What is the standard employer premium payment grace period and are you making any changes to that policy?
Answer: Blue Cross and BCN will continue with our current grace periods – for fully insured customers this is a 30-day grace period. We recognize, however, that COVID-19 is rapidly changing our health care ecosystem and we will continue to assess our approach.

Question: Will Blue Cross and BCN allow employers to modify open enrollment, new hire, reinstatement policies after returning from furlough?
Answer: Yes, Blue Cross and BCN will allow and is willing to waive waiting periods. Groups can re-add employees through the usual membership processes.

Question: Will Blue Cross and BCN re-rate experience-rated insured coverage or stop loss for changes in contracts or other fluctuations in eligibility that are driven by responses to the COVID-19 pandemic?
Answer: We realize that there may be several types of unique eligibility changes that occur in the near-term in response to COVID-19. To avoid creating concerns for our group customers we will place a temporary hold on our re-rating practices related to large changes in enrollment until further notice.

Question: For customers that are experiencing a change in membership due to COVID-19, will Blue Cross and BCN allow the employer to self-adjust their bill?
Answer: Group customers or agents should not self-adjust the bill. Membership changes will automatically be applied in the group’s next billing cycle. If there is more than a 25% change in the group’s fully insured membership, groups should work with their managing agent or Blue Cross account representative before the due date.

Note from Mason-McBride: Additionally, any questions about cost-sharing with employees during this time will need to be directed to your attorney and/or CPA.

BCBSM/BCN Helpline and E-mail specifically for small group employers

To help employers navigate these difficult times, Blue Cross Blue Shield of Michigan and Blue Care Network have established a helpline and mailbox to field inquiries from small group customers. The purpose of the helpline and mailbox is to assist with Blue Cross Blue Shield of Michigan’s policies, small business resources, requests for support, and other issues connected to COVID-19.

Please note: The helpline and mailbox aren’t intended for questions related to claims or health care treatments. Those inquiries should continue to be directed to Blue Cross and Blue Care Network’s Customer Service centers.

Small group COVID-19 helpline: 1 (866) 582-5052 from 8 a.m. to 5 p.m. ET, Monday through Friday.
Email inquiries: smallgroupcovid19@bcbsm.com

Blue Cross Blue Shield of Michigan Update: March 5, 2021
Blue Cross extends waiver of COVID-19 treatment cost-sharing through September 30, 2021

During the pandemic, Blue Cross Blue Shield of Michigan and Blue Care Network have taken actions to help support our customers and members.  The actions included waiving member cost-sharing to help support our customers and members.  The actions included waiving member cost-sharing for COVID-19 treatments through December 31, 2020.  As COVID-19 continues to affect our customers and members, Blue Cross and BCN have decided to extend the time frame for covering the cost-sharing waiver for COVID-19 treatment through September 30, 2021.

This applies to all commercial and Medicare Advantage members.

We’ll also continue to cover physician-approved testing and associated services for the duration of the public health emergency, as required by federal guidelines.  As the pandemic continues, we at Blue Cross want to ensure that members can get the care they need during these difficult times.

Blue Cross Blue Shield of Michigan members will have COVID-19 testing and treatment provided at no cost, expanded telehealth services 

Blue Cross Blue Shield of Michigan and Blue Care Network are expanding coverage for services related to COVID-19:  waiving all member copays, deductibles, and coinsurance for COVID-19 testing and treatment. They are also expanding no-cost telehealth services to include common behavioral health therapy services.

The coverage is effective immediately and applies to all individual medical, Medicare Advantage, and Medicare Supplemental plans.

For COVID-19 testing and treatment
• BCBSM and BCN will waive member cost-sharing for physician-authorized COVID-19 testing. In line with the Families First Coronavirus Response Act, COVID-19 testing and all services that result in ordering or administration of a COVID-19 test will be covered without member cost-share as of March 18, 2020. Testing and associated services must be consistent with CDC guidelines.
• Blue Cross will waive member cost-sharing for all COVID-19 treatment through June 30, 2020. Blue Cross will cover, with no member cost share, all COVID-19 treatment provided to members on an inpatient or outpatient basis, from both in-network and out-of-network providers.

For telehealth services
• BCBSM/BCN is extending no-cost telehealth services to members with existing telehealth benefits through at least June 30.
• BCBSM/BCN is expanding these services to include common behavioral health therapy services in addition to including some of the most common office visits and hospitalization follow-ups.
• These changes apply to care received through in-network providers as well as care received through Blue Cross Online Visits and are effective as of March 16, 2020.


Cigna


Cincinnati


Colonial Life


Dearborn National


Delta Dental’s Pandemic Relief Program


Delta Dental


Employee Benefits Corporation


EHIM


Eyemed

Updated May 5, 2020
Numerous governors have unveiled their state-specific, phased plans to reopen regional economies, including healthcare. And we anticipate each state will have different recommendations and expectations for optometry practices. Our EyeMed team will:
• Continue paying close attention to all the state-specific guidelines and phased plans, and stay connected to leading optical organizations such as the American Optometric Association and the National Association of Vision Care Plans,
• Maintain close, continuous contact with both our retail and independent provider communities to understand how they are preparing to equip their offices and change protocols to begin providing both routine and essential services.
Of course, as we continue to learn and expand on our EyeMed plans, we will continue to share information with you. We’re already receiving questions from many of our strategic partners such as yourself, so we’ve summarized some key updates:

• Reopening the EyeMed Home Office & Operational Readiness
• Exceeding member expectations
• Projected utilization surges
• Provider & Network readiness
Eyemed Member Benefits FAQ
EyeMed COVID-19 Updates by State

Should you need glasses or contacts while social distancing, please remember you can use your in-network benefits from the comfort of your home at participating online providers. Benefits are applied automatically, and glasses will be delivered right to your home. Under the circumstances, many of these online providers are offering free expedited shipping and no-cost returns for extra convenience.*

If you do choose to visit a provider in person, we recommend calling your provider directly to verify amended store hours or closing. You have 24-hour access to the Provider Locator. Customer Care Center: 1-866-939-3633.


Guardian


The Hartford


Health Alliance Plan (HAP)

Offers Extended Financial Relief for Members for the Duration of 2020 in Response to COVID-19 Pandemic

Health Alliance Plan (HAP) Update, April 5, 2021

HAP will extend the following member cost-sharing waivers for testing, treatment, and telehealth services related to COVID-19 through September 30, 2021:

  • HAP will continue to waive member cost-sharing for COVID-19 diagnostic tests and test-related visits. This cost-sharing waiver applies to testing from in-network or out-of-network providers. Member cost-sharing for all other diagnostic tests will continue to apply. Self-insured employer group customers control their own health benefits, and HAP is working with its self-insured customers to determine how they will cover testing.
  • HAP will continue to waive member cost-sharing for treatment related to an acute diagnosis of COVID-19 infection. This cost-sharing waiver is for inpatient or outpatient treatment from an in-network provider. HAP does not waive cost-sharing for treatment of ongoing complications stemming from a previous COVID-19 diagnosis.
  • HAP will continue to waive cost-sharing for its individual, fully insured employer group, Medicare, Medicaid, and MI Health Link members using telehealth services related to a COVID-19 diagnosis. Member cost share will apply for telehealth services not related to an acute diagnosis of COVID-19 infection. Self-insured employer group customers control their own health benefits, and HAP is working with its self-insured customers to determine how they will cover telehealth services.
  • HAP is taking these steps because we want to do all we can to help our members get the care they need, especially at this time when many individuals and businesses are struggling to recover financially from the pandemic.


HAP | Henry Ford @ Work | COVID-19 Return to Work Navigator:
Program Update, October 22, 2020

Henry Ford @ Work is the direct-to-business division of Henry Ford Health System. Their individualized services are tailored to you and your workforce.  They develop custom models of health and wellness in collaboration with you to ensure that your workforce is safe, healthy, and productive.  They offer their tailor services through many modalities, including:

  • On-site and near-site clinics.
  • Mobile services.
  • Telemedicine.

This is a simple, convenient, frictionless process to manage your team members who require a COVID-19 assessment and follow-up.
This program (available with a subscription fee per employee per month and an all-inclusive service fee, invoiced monthly) provides employers with a single, controlled process to manage employees who may need COVID-19 testing. In summary:

  • The Return to Work Navigator program is an all-inclusive service for employees who are suspect of having contracted COVID-19.
  • The Return to Work Navigator Program will provide employees with access to personalized video consultations with a Henry Ford provider, to convenient and safe COVID-19 testing, results reporting, and case management support.

What’s included:

  • One number for your employees to call when they become symptomatic.
  • Secure video visit with a Henry Ford provider.
  • Access to quick and convenient Henry Ford drive-through testing centers.
  • Results communicated within 24 hours via a secure mobile application.
  • Case management support to return back to work safely.
  • Protected health information waiver so employees can elect to have Henry Ford share the results of their test with their employers.
  • Reporting services that will keep you — the employer — abreast of employees who are confirmed positive and their expected return to work date.

To learn more about Henry Ford @ Work, call 313-874-6035 or email B2W@hfhs.org

 

HAP Members – Free Home Delivery Service for Prescription Drugs

HAP’s free home delivery service for prescription drugs through Pharmacy Advantage saves members time while making life easy and safe.

WHO DOES THIS APPLY TO?
• All HAP members

WHAT SERVICES ARE AVAILABLE THROUGH PHARMACY ADVANTAGE?
• Free delivery service, including out of state
• Up to a 90-day supply of most medications
• Same day medication fill
• Refill reminders and auto-shipment
• Assistance for medication changes or prior authorizations
• Assistance from health experts about medications

HOW IS HAP ENSURING ITS MEMBERS HAVE AN ADEQUATE DRUG SUPPLY ON HAND?
• Early refills
• Free home delivery service through Pharmacy Advantage

HOW CAN MEMBERS ENROLL FOR FREE HOME DELIVERY THROUGH PHARMACY ADVANTAGE?
There are three easy ways:
• Visit hap.org/delivery and click on Sign Up.
• Fill out the form at hap.org/delivery.
• Call (800) 456-2112, Monday through Friday, from 8 a.m. to 6 p.m.

IS THERE MESSAGING I CAN SHARE WITH EMPLOYEES?
The following messaging can be shared:

HAP is here, offering all HAP members free home delivery for prescription drugs.
Members-only pay their prescription copay.
Save time while making life easy and safe. Use Pharmacy Advantage service to get:
• Free delivery service, including out of state
• Up to a 90-day supply of most medications
• Same day medication fill
• Refill reminders and auto-shipment
• Assistance for medication changes or prior authorizations
• Assistance from health experts about your medications
To get started, go online to hap.org/delivery or call Pharmacy Advantage at (800) 456-2112, Monday through Friday, from 8 a.m. to 6 p.m.

WHERE SHOULD HAP MEMBERS BE DIRECTED FOR MORE INFORMATION?
hap.org/prescription-drug: information on prescription drug coverage
hap.org/delivery: information on how to get started with home delivery, Frequently Asked Questions (FAQs) and more
• Pharmacy Advantage at (800) 456-2112 Monday through Friday, from 8 a.m. to 6 p.m.
• HAP Customer Service at (800) 422-4641 (TTY: 711), Monday-Friday, from 8 a.m. to 7 p.m.

WHO CAN I CONTACT FOR MORE INFORMATION?
Please email your HAP representative. A contact list can be found
at hap.org/employers/contact.

Health Alliance Plan (HAP) Frequently Asked Questions: Fully-insured group membership and premium payment policies during COVID-19

Will HAP allow employers to continue health care coverage for currently enrolled employees who are temporarily laid off or have had their hours reduced?

  • Yes, HAP will allow if the employer considers their employees actively employed (whether temporarily laid off or working reduced hours), their coverage can continue.
  • If an employer temporarily “terminates” an employee from their payroll system so that the person can collect unemployment, it is up to the employer to determine if they consider that person an active employee who will be returning to work.  If yes, they can continue their health care coverage.
  • It is up to the employer group to monitor and manage their enrollment.
  • The employer is responsible for continuing to pay the premiums.
  • HAP will re-evaluate these parameters at the end of April.

How will HAP handle new hires that are in their probationary/new-hire period?
The waiting period will not be affected for employees who were in their new hire/probationary period as of March 12, 2020 and are temporarily laid off or their hours are reduced.

If an employer needs to terminate employees temporarily from their health care coverage during this time, can they reinstate the employees’ health care coverage after they return to active employment without satisfying their waiting period?
Yes, when existing employees return to work, we will waive waiting periods for any group that does not have “immediate coverage” for employees indicated in their re-hire policy.

Is HAP allowing a special open enrollment while we are working through COVID-19 issues for those employees who previously waived coverage?
To help employees have access to care who may have previously waived coverage, we are providing fully insured small group clients the ability to establish a special enrollment opportunity, due to COVID-19, to enroll employees who did not previously enroll.

The opportunity will be limited to employees who previously did not elect coverage for themselves (spouses, children) or waived coverage. The enrollment opportunity will extend from March 24 to April 30, 2020.

What if an employer needs to make enrollment changes due to life events and they are unable to do so right now?
From March 24 through April 30, 2020, an employer may make enrollment changes for employees and their eligible dependents within 60 days.  Employers can continue to send an email with eligibility changes to MB_Enrollment@hap.org or self-serve using the Employer Portal at www.hap.org.

What is HAP’s standard premium payment grace period?
We plan to continue with our grace period as defined today.  For insured employer groups, we have a 30-day grace period.  COVID-19 is impacting us greatly and we will continue to monitor and adjust our approach as we see necessary.

What if employers cannot afford to pay their premiums, due to loss of business or shut down?  Is there any relief?
We are handling this on a group by group basis; the employer group should reach out to HAP to discuss.  We will work closely with our agents and employer partners to determine the best course of action. 

If employers can no longer afford to continue covering their employees, what options do they have?
HAP has individual plans available at hap.org or by calling (855) 948-4427.  Documentation showing loss of coverage will be needed – that can be obtained by calling HAP’s customer service at (313)872-8100.  Employees seeking assistance can go to www.healthcare.gov to find ACA plans that may offer premium tax credits.

Will HAP re-rate experience-rated groups due to fluctuations in eligibility due to the COVID-19 pandemic?
We do expect eligibility changes as a result of COVID-19.  However, we have no plans to re-rate or change established rates due to these eligibility shifts in the short term.

HAP Waives Cost-Sharing for Testing and Treatment of COVID-19

Effective immediately, HAP will waive member cost-sharing for testing and treatment of COVID-19, according to state and federal guidelines. This includes deductibles, copays, and co-insurance associated with treatment for the virus. HAP’s cost-share waiver is effective February 4, 2020. This is the first day the Centers for Medicare and Medicaid Services (CMS) began using a common diagnostic code to test for COVID-19. This code is currently in effect for services rendered through June 30, 2020.

Telehealth visits are an important line of defense during the COVID-19 pandemic. HAP will also be extending the waiving of cost-sharing for HAP individual, fully-insured group and Medicare members using Telehealth and Virtual services through June 30, 2020. There will not be cost-sharing even if the service is not related to COVID-19. HAP had previously announced the waiving of cost-sharing for COVID-19 testing and telehealth services through April 30, 2020.

Are telehealth visits a good option to use right now?
What’s the cost for this service?

Telehealth visits are a good option to use during this time of the pandemic. Currently, some insurance companies are waiving the co-pays associated with telehealth visits to support the use of these types of services as well as lessen the contact of in-person visits if someone is contagious.

Check with your insurance company’s website for your coverage. Use nurse and telehealth lines when offered by your carrier for you and your covered family members to obtain medical services and advice from the comfort of your own home.

Additionally, we recommend utilizing additional carrier resources, such as member portals and free member mobile applications.

How much does COVID-19 testing cost if I or someone in my family needs to be tested?

We’ve seen most health insurance carriers waive the COVID-19 test fee at this time. Some insurance companies are waving ancillary costs, such as office visits, co-pays, and coinsurance, too. If you have a network plan, be mindful. Utilize participating providers to reduce your costs as well as remove any billing surprises. Note that even if the test fee is waived, you may still be responsible for any lab fees.


HealthEquity

HealthEquity Update — December 1, 2020

0% cost-share for COVID-19 treatment extended, $0 cost-share for vaccine, and more!
Throughout the year we’ve been monitoring the effects of the COVID-19 pandemic and amending our coverage so that members get the right care at the right time in the right place.

Priority Health will continue to waive all copays, deductibles, and coinsurance for medically necessary treatment of COVID-19 through Mar. 31, 2021 for fully funded Commercial, Individual, Medicaid, and Medicare members when they receive treatment at an in-network provider. Self-funded groups can continue to choose their benefits coverage for their employees and dependents.

To continue to support all Commercial Group employers we’ve extended coverage for furloughed employees through Mar. 31, 2021.

To protect the most vulnerable populations, we’ll continue to waive all cost-sharing for Medicare Advantage members for in-person and telehealth primary care visits through Mar. 31, 2021.

Additionally, Priority Health will offer $0 cost-share coverage for the COVID-19 vaccine to all members once it is made available to the public.

As a reminder, we’ve supported members throughout the pandemic by:
• Providing medically necessary testing coverage in accordance with the Families First Coronavirus Response act until the end of the federal public health emergency
• Offering financial support to members and employers through premium credits
• Extending $0 virtual visits for primary care, specialists, and behavioral health, for most fully funded Priority Health members, including Medicare Advantage members* (starting Jan. 1, 2021)
• Providing free access for all members to COVID-19 content from myStrength, an online mental wellness tool
• Accelerating value-based payments and quality bonuses to offer physician and provider partners financial stability

*Excluding the Medicare Advantage Vital plan, which has 20% coinsurance for virtual visits.


Humana

Humana Employer FAQs

Humana Employer Info Hub

Humana Information, Updated July 30, 2020

Humana is proud to be the first insurer to offer LabCorp® at-home COVID-19 test kits and drive-thru COVID-19 testing at hundreds of Walmart Neighborhood Market pharmacies across the country. Member cost share for this testing is waived for all eligible medical plan members.

Members can use our Risk Assessment tool, to answer a few simple questions about your risk factors and receive guidance on what to do next. If testing is recommended, members can opt to have a testing kit mailed to their home within one business day. If you prefer a drive-thru test, Humana has teamed up with Walmart, Quest Diagnostics, and PWNHealth to offer drive-thru testing at Walmart Neighborhood Market pharmacies. The pharmacy staff will give their members a test kit and be there to help them complete the process correctly. See the full details in our FAQs.

Here’s an informational flyer.

Humana is continuing to waive all member costs (co-pays, deductibles, co-insurance) related to covered COVID-19 testing and treatment.

Our response goes beyond a one-time announcement. We’re working hard to make it easy for you and your employees to get the care you need, how and when you need it. That’s why, through the end of 2020, we’re waiving member out-of-pocket costs for telehealth visits (also known as telemedicine) with participating in-network providers, including routine visits for primary and specialty care and even behavioral health services.

Humana is providing safety kits to all medically insured members: approximately 6.4 million people. The safety kit contains two washable face masks, as well as health advice and information about how Humana can support our members as they seek care. Members will begin to receive the safety kits at their homes in this month.

Need more than two? In order to support a safe return to the workplace, Humana has collaborated with JPR Medical to secure preferred pricing on personal protective equipment (PPE) for all employers. Visit humana.jprmedical.com to learn more.

Enabling coverage for laid-off employees extended. We have extended the relaxation of the requirement that employees need to be actively working to be eligible for coverage. This allows employers to cover employees who have been laid-off, through Sept 30, 2020. See the full details in our FAQs.

• Ongoing guidance for managing through the coronavirus pandemic. Visit our COVID-19 Employer Resource Center for timely and relevant coronavirus information and resources to help you manage through this ongoing pandemic. You can view past webinars and access downloadable resources at your convenience.

Please continue to reach out to your local representative as a resource or use the dedicated service line for all your COVID-19 related questions. You can contact our team by phone (1-800-592-3005) or email (COVIDquestions@humana.com).


John Hancock


Liberty Union


Lincoln Financial


McLaren Health Plan

McLaren Health Plan Q & A

TEMPORARY LAYOFFS/CLOSINGS/COBRA
Q: How long can employees remain covered with McLaren Health Plan if an employer needs to close their business temporarily due to a virus outbreak or needs to temporarily layoff or furlough employees, but they want to keep their benefits?
A: McLaren Health Plan will temporarily continue to provide coverage if a business closes, temporarily lays off employees, or cuts hours for employees due to the COVID-19 outbreak. At this time, coverage may only continue through July 31, 2020. It is the employer’s decision whether to continue to offer benefits – not McLaren Health Plan’s. Employers must continue to pay premiums according to the current payment policy to maintain coverage. McLaren Health Plan will continue to monitor and evaluate the situation over the coming weeks.

Q: Will McLaren Health Plan require employers to immediately move laid-off employees to COBRA?
A: If an employer opts to provide coverage for employees on temporary layoff, the employer will not be required to move the employees to COBRA. At this time, coverage may only continue through July 31, 2020. It is the employer’s decision whether to continue to offer benefits – not McLaren Health Plan’s. Employers must continue to pay premiums according to the current payment policy to maintain coverage. McLaren Health Plan will continue to monitor and evaluate the situation over the coming weeks. COBRA will apply upon loss of coverage.

Q: Will McLaren Health Plan have a set time period for which employees who are laid off can remain on an active policy vs. being moved to COBRA?
A: The employer determines eligibility. If the employer chooses to provide coverage and continues to pay premiums according to the current payment policy, the employees will be covered through July 31, 2020.

Q: Will McLaren Health Plan waive underwriting requirements to allow employers to pay for benefits while employees are receiving unemployment benefits?
A: Yes. McLaren Health Plan will waive underwriting requirements through July 31, 2020. We will continue to monitor the situation and adjust accordingly as needed.

Q: Will McLaren Health Plan waive waiting periods for workers returning to work after furlough or layoff as a result of the COVID-19 pandemic?
A: Yes. McLaren Health Plan will waive the waiting period to reinstate employees if the employer did not elect to continue coverage during layoff or furlough.

Q: If an employer is unable to make eligibility changes, i.e., add or remove employees and/or dependents due to qualifying life events within the 30 days required due to COVID-19, what can they do?
A: McLaren Health Plan will work with employer groups to allow changes past the 30-day timeframe through July 31, 2020 for fully funded employers.

Q: Is there a requirement to alter any group provisions/policies if it is a result of the COVID-19 emergency mandates?
A: No. At this time we will not require any changes to plan documents or policies due to the declared state of emergency. McLaren Health Plan will continue to assess as new information becomes available.

 

McLaren Health Plan Premium Information

Q: Will McLaren Health Plan provide any grace period for premium payment for individuals or employer groups?
A: McLaren Health Plan is committed to supporting our groups and members. Since the premium is prepaid, groups are currently paid through June 30, 2020. For fully insured customers, we currently have a 30-day grace period. McLaren Health Plan will extend this by an additional 15 days, so customers will have until August 15, 2020 to remit payment. This also applies to individuals insured with McLaren Health Plan off the Exchange. On-Exchange individuals will follow the normal process.

Q: Will McLaren Health Plan permit any leniency related to premium payments if small businesses are forced to close part of their business due to the Governor’s orders?
A: McLaren Health Plan is committed to supporting our groups and members. Since the premium is prepaid, groups are currently paid through June 30, 2020. For fully insured customers, we currently have a 30-day grace period. McLaren Health Plan will extend this by an additional 15 days, so customers will have until August 15, 2020 to remit payment. This also applies to individuals insured with McLaren Health Plan off the Exchange. On-Exchange individuals will follow the normal process.

Q: Will McLaren Health Plan waive copays, deductibles, and coinsurance during the COVID-19 pandemic?
A: Yes. McLaren Health Plan will waive copays, deductibles, and coinsurance for diagnoses related to COVID-19 for all lines of business through July 31, 2020.* This may not apply to self-funded or high-deductible health plans.
*Or earlier, if businesses resume normal operations.

Q: Will McLaren Health Plan cover virtual visits if a provider office is only doing online visits?
A: A telemedicine visit is a visit that can be done over the phone with a doctor. This is a good way to help prevent the spread of infections like COVID-19. COVID-19 testing-related services received through telemedicine are a covered benefit for McLaren Health Plan members with no cost-sharing. The doctor will determine if the member needs the COVID-19 test and will tell the member what to do next.

Telemedicine visits are also covered with your doctor for healthcare needs not related to COVID-19. These visits are subject to your normal office visit cost-share responsibility.

Q: Will McLaren Health Plan waive the online office visit copay through Virtuwell for someone who uses it for symptoms of the coronavirus?
A: McLaren Health Plan’s online office visit option, www.virtuwell.com allows members to have a virtual office visit with a board-certified nurse practitioner. The office visit copay will be waived through July 31, 2020* for services related to COVID-19.
*Or earlier, if businesses resume normal operations.

Q: How will McLaren Health Plan cover testing for COVID-19?
A: McLaren Health Plan will cover the cost of medically necessary COVID-19 tests for all members with no member cost-sharing for both in-network and out-of-network providers, including those with high deductible health plans through July 31, 2020.* The most recent IRS guidelines allow for this coverage. https://www.irs.gov/newsroom/irs-guidance

For all members, McLaren Health Plan will cover the two codes released by the Centers for Medicare & Medicaid Services (CMS), U0001 and U0002 and 87635, for laboratory testing. We will cover these two codes at 100% of allowed charges with no member cost-sharing through July 31, 2020.* McLaren Health Plan will also waive the costs of items and services related to the furnishing or administration of the testing provided to an individual during a health care provider office visit, urgent care center, an emergency room visit, or through a telehealth visit through July 31, 2020.*
*Current “Emergency Declaration” is set to end July 16, 2020. If lifted early or extended, this date could change.


MetLife


Mutual of Omaha


Priority Health

Priority Health Offers Financial Relief for Members and Employers in Response to COVID-19

Priority Health — for Employers

Priority Health — for Members

Priority Health will continue to waive all copays, deductibles, and coinsurance for medically necessary treatment of COVID-19 through September 30, 2021 for fully funded Commercial, Individual, Medicaid, and Medicare members when they receive treatment at an in-network provider.  Self-funded groups can continue to choose their benefit coverage for their employees and dependents.

Additionally, Priority Health will offer $0 cost share coverage for the COVID-19 vaccine to all members as it becomes available to them.


Principal

Principal is giving a premium credit of 10% for the months of June 2020 – October 2020 to employers, based on the prior month’s billed premium, who have a fully insured dental policy with them.*
These employers will be notified by email on May 7, 2020 and will see the credit on their group dental coverage bills.  *Self-accounting customers can calculate a 10% reduction in premium for their June-October 2020 billing.


Reliance Standard


Sun Life


Symetra


Total Health Care USA


Total Health Care USA, Updated December 9, 2020

Extended $0 Cost Share for COVID-19 Treatment, Vaccine, and More
Throughout the year, we’ve been monitoring the effects of the COVID-19 pandemic and amending our coverage, so that members get the right care at the right time in the right place.

Total Health Care USA will continue to waive all copays, deductibles, and coinsurance for medically necessary treatment of COVID-19 through March 31, 2021 for all Group Commercial and Individual members when they receive treatment at an in-network provider.

To continue to support all employers, we’ve extended coverage for furloughed employees through March 31, 2021.

Additionally, Total Health Care USA will offer $0 cost-share coverage for the COVIS-19 vaccine to all members once it is made available to the public.

As a reminder, we’ve supported members throughout the pandemic by:

  • Providing medically necessary testing coverage in accordance with the Families First Coronavirus Response Act until the end of the federal public health emergency.
  • Offering financial support to members and employers through premium credits.
  • Extending $0 virtual visits for primary care, specialists, and behavioral health for all our group members when rendered by a THC provider.
  • Extending $0 for virtual visits through Teladoc® for both group and individual plans.

 

Total Health Care USA, Updated November 19, 2020

THC Is Bringing Back the House Call:  Teladoc® and Virtual Visits for Small and Large Groups

Teladoc has proven to be an effective and convenient alternative to urgent care and emergency room visits in many circumstances.  And virtual visits with THC doctors are continuing to increase in popularity among patients and providers alike.

In light of the current pandemic, these services have become more valuable than ever.  To make them better, Total Health Care USA has decided to continue offering Teladoc and in-network virtual visits FREE to our Small and Large Group Members.  No copays.  No deductibles for all group plans including HDHP.

Here are some details about how and when this coverage will be implemented for each kind of group.

Small Group

  • We will be extending our commitment to cover Teladoc and in-network virtual visits 100% before deductible for all Small Groups through to their renewal in 2021.
  • Upon 2021 renewal, this coverage will be built into Small Group plan documents in writing.

 

Large Group

  • We will also be extending our commitment to cover Teladoc and in-network virtual visits 100% before deductible for all Large Groups through to their renewal in 2021 (or 2022 for Large Groups renewing in January or February).
  • For plans renewing between March and December 2021, this coverage will be built into Large Group plan documents in writing at the time of renewal.
  • For plans renewing in January and February of 2021, this coverage will not appear in plan documents in writing until 2022 renewal, but will nonetheless continue to be a benefit in all Large Group plans.

 

Total Health Care USA, Updated May 27, 2020

Due to lower utilization of health services, as well as our efforts to keep administrative costs low, we’ll be offering premium credits and waive cost-sharing for our group customers in the following ways:

  • Small group employers (2 -50 employees):  A 15% premium credit will be issued in July 2020 and August 2020 invoices against premiums billed for May and June.
  • Large group employers:  These groups will receive consideration for premium credit upon renewal, beginning with fourth quarter 2020 renewals.  We’ll share more information on this as it becomes available.Other Total Health Care USA Information:
  • Total Health Care USA pays a $45 copay for Teladoc for all non-HDHP plans all of the time.
  • Total Health Care USA will provide health insurance benefits to employees who are laid off due to the Coronavirus when the employer continues to pay their health insurance premium.  The employer must provide coverage to all laid-off employees and not pay premiums on select individuals.  If an employer is not willing to pay the premium for a laid-off employee, then they can select COBRA if they are eligible.
  • In response to the rapid spread of the Coronavirus COVID-19, Total Health Care USA is relaxing restrictions on early prescription refills effective immediately. In the event a prescription is rejected because it is being refilled too soon, pharmacists in Michigan are authorized to override the rejection immediately.
  • Starting April 1, 2020 through June 30, 2020, Total Health Care USA will be covering the full cost of inpatient and outpatient medical care related to the testing and treatment of COVID-19 from an in-network provider for our
    group members.
  • Q: What information is Total Health Care USA able to provide employer groups that are applying for the Paycheck Protection Program loans made available through the CARES Act?
    A:  Employers may need to provide information on health care premiums for up to 24 months. Some individual lenders may request copies of invoices. A report supplying this information will be provided upon request. Copies of invoices are available if required by the lender. Please email your group name, group number, and the time period for reporting to pfritz@thcmi.com.

Trustmark


Superior Vision


Ulliance


UnitedHealthcare

Updated January 13, 2021
Like all of you, we are concerned about the impact that COVID-19 could have on the health and wellbeing of the people we serve.

UnitedHealthcare has a team closely monitoring COVID-19 and, as with any public health issue, we are working with and following all guidance and protocols issued by the U.S. Centers for Disease Control and Prevention (CDC), Centers for Medicare & Medicaid Services (CMS), Food and Drug Administration (FDA), state and local public health departments in supporting our members’ needs.

To help ensure our members have access to care, UnitedHealthcare is waiving member cost-sharing for inpatient treatment through 1/31/21 if care is received at an in-network facility for its fully-insured group market health plans and Medicare Advantage plans. For All Savers customers, we will also cover these expenses, which means they will be paid under your plan and through UnitedHealthcare stop-loss policies.

Thank you for your patience and support as the situation continues to evolve during this challenging time. We will continue to keep you updated as we have additional guidance and guidelines. In the meantime, if you would like to discuss any aspect of this proposal or other steps we are taking related to COVID-19, please contact All Savers Customer Call Center at (866) 405-7174.

UnitedHealthcare Cost-Sharing Updates for COVID-19

UnitedHealth Group to Provide Over $1.5 billion in Assistance and Premium Support to Customers


Unum

Unum has a dedicated email for COVID-19-related questions: COVID19questions@unum.com.


VSP

VSP Members — Accessing Essential Medical Eye Care (April 2020)


General Group Benefits Questions and Concerns

doctor holding a #covid19 sign


What about prescriptions for my family and myself? Especially if we have maintenance medications – can I get prescriptions filled early?

Some insurance companies are allowing early refills of prescriptions. Some are 30 days in advance, or even allowing a 90-day supply if using a mail-order program.  Please be mindful so as not to decimate the drug supply. Opioids are not considered for early refills. Check with your carrier for your particular situation.


Will my family or I need any prior authorizations for care?

Some insurance companies are relaxing prior authorization requirements, but we recommend ALWAYS coordinating with your primary care physician.

Can I be reimbursed for COVID-19 expenses through my Flexible Savings Account (FSA)?

As a general guideline, purchases being made for prevention to reduce the spread of the virus such as face masks, hand sanitizers, and disinfectants will more than likely not be eligible for reimbursement.  On the other hand, first aid kits, steam vaporizers, and thermometers are FSA-reimbursable expenses that may be useful at this time.

It is important to note that each FSA plan is unique regarding what qualified expenses will be reimbursed, so consult your Summary Plan Description (SPD) to know which expenses your plan deems eligible.  Here’s a full list of FSA-eligible items from the IRS.

The FSA Store has created a list of FSA-eligible items to help prepare.

What about disability insurance and COVID-19?

COVID-19 is a completely unprecedented situation. What we’ve seen from carriers is individuals will be considered disabled as long as they meet the definition of disability which may or may not be the same as the quarantine period. Carriers say cases will be evaluated on a case by case basis. Contact us regarding any particular situation.

What if a member of the employee’s household is diagnosed with COVID-19, and then the employee is also quarantined as a precaution, even though they haven’t yet been diagnosed? Is that considered a disability for the employee?

Overall, the answer is no. But again, carriers are evaluating on a case-by-case basis.


Commercial Insurance:  Business Interruption Functions

 

three working professionals gathered outside on sidewalk wearing masks

We have received questions regarding how business interruption functions relate to the current COVID-19 issue. Traditional business interruption insurance coverage requires that the suspension of business must be caused by a direct physical loss of, or damage to the covered property in question.

Also, that loss or damage must be caused or result from a covered cause of loss. In addition, viruses or diseases are not typically an insured peril.

That said, we recommend that any incidents which may or may not arise to a claim status be submitted to the applicable insurance carrier for analysis and determination. Please contact your Account Executive and Account Manager to discuss your particular and specific situation.

What about employee eligibility?

If you have employees that are enrolled on your benefit plans and have exceeded their PTO or are laid off/provided leaves, we recommend consulting legal counsel to obtain guidance about how the definition of reduction in hours may affect their continued eligibility on your various plans.  Technically, once an employee has a reduction in work hours to a certain level, they may no longer qualify for enrollment in the benefit plans and need to be terminated. They would then be eligible for COBRA if your business qualifies to offer COBRA.  Given the unique nature of the current environment consultation with legal counsel is warranted.

 


The Families First Coronavirus Response Act (FFCRA)

chalkboard with families first coronavirus response act written

President Trump signed into law, ”The Families First Coronavirus Response Act” (the law) on March 20, 2020. It becomes effective in 15 days, (April 2, 2020). The key employment-related aspects of the law are provided below.

The law provides two leaves, Paid Sick Leave and Paid Public Health Emergency Leave Under the Family and Medical Leave Act. The law only applies to employers with fewer than 500 employees. Part-time employees are included in this count to assess coverage. Further, the below provisions can also be affected by specific state and local laws.

Paid Sick Leave
Employers with fewer than 500 employees will be required to provide full-time employees with 2 weeks (80 hours) of paid sick leave for the following reasons:

  • To self-isolate because of a diagnosis of COVID-19, or to comply with a recommendation or order to quarantine due to exposure or exhibition of symptoms;
  • To obtain a medical diagnosis or care if the employee is experiencing symptoms of the coronavirus;
  • To care for a family member who is self-isolating due to a diagnosis of coronavirus, experiencing symptoms of coronavirus and needs to obtain medical diagnosis or care, or quarantining due to exposure or exhibition of symptoms; or
  • To care for a child whose school has closed or childcare provider is unavailable, due to the coronavirus.

Employers must compensate employees for any paid sick time they take at their regular rates of pay (unless the leave is being used to care for a family member or child, in which case the employee is only entitled to two-thirds of his or her regular rate of pay). The sick leave is available for immediate use by employees, regardless of the length of employment.

Additionally, part-time employees are entitled to the number of hours of paid sick time equal to the number of hours they work, on average, over a 2-week period.

Employers who already provide paid leave to employees on the day before the law is enacted must provide this paid leave in addition to any paid leave already provided-and may not change their paid leave policies on or after the date of enactment to avoid compliance. Finally, employers cannot require employees to utilize other paid leave before using the paid leave provided by this bill.

This part of the law would also expire on December 31, 2020.


Paid Public Health Emergency Leave Under the Family and Medical Leave Act

family medical leave act written on a chalkboard

Employees of employers with fewer than 500 employees can be provided with the right to take up to 12 weeks of public health emergency leave under the Family and Medical Leave Act (“FMLA”).

Ten of these twelve weeks are be paid at a rate of no less than two-thirds of the employee’s usual rate of pay. (FMLA leave for all other purposes remains unpaid.) The first two weeks will be paid by Paid Sick Leave above.

To be eligible for paid leave, employees must have been on the employer’s payroll for 30 days and may use emergency FMLA leave for the following reasons:

  • To care for a child of an employee if the child’s school or place of care has been closed, or the childcare provider is unavailable, due to the coronavirus. The first two weeks of leave may be unpaid; the employee may choose to substitute accrued paid time off or other medical or sick leave during this period, but an employer cannot require an employee to do so. After the first two weeks of unpaid leave, employers must continue paid FMLA leave at a rate of no less than two-thirds of the employee’s usual rate of pay.
  • As with traditional FMLA leave, this leave is job-protected and an employer must return the employee to the same or equivalent position upon their return to work. This new law outlines an exception for employers with less than 25 employees if the employee’s job no longer exists due to the coronavirus pandemic, which requires employers to make reasonable efforts to restore the employee to an equivalent position over a one-year period.
  • The Secretary of Labor has the authority to issue regulations exempting: (1) certain health care providers and emergency responders from taking leave under the bill; and (2) small business with fewer than 50 employees from the requirements of the bill if it would jeopardize the viability of the business. This amendment to the FMLA would expire on December 31, 2020. Within seven days from enactment, the Secretary of Labor will provide a model notice to be posted in areas that are readily accessible to employees (e.g., kitchens and breakrooms) regarding the law. We anticipate direct notice might also be required in the form of an email or letter.Tax Credits for Paid FMLA and Sick Leave and Grant of $1 Billion Dollars for Emergency Unemployment Insurance
    A series of refundable tax credits are for employers providing paid emergency sick leave or paid FMLA. The credits are as follows:
  • A refundable tax credit for employers equal to 100 percent of qualified family leave wages required to be paid that are paid by an employer for each calendar quarter. The tax credit is allowed against the tax imposed on the employer portion of Social Security taxes. The amount of qualified family leave wages taken into account for each employee is capped at $200 per day and $10,000 for all calendar quarters. If the credit exceeds the employer’s total liability for Social Security taxes for all employees for any calendar quarter, the excess credit is refundable to the employer.
    A refundable tax credit for employers equal to 100 percent of qualified paid sick leave wages that are paid by an employer for each calendar quarter. The tax credit is allowed against the tax imposed by the employer portion of Social Security taxes (6.2% of wages).
  • One billion dollars in grants to states for emergency unemployment insurance, half of which would be transferred to the states within 60 days after the enactment of the bill (so long as the state complies with certain requirements, such as requiring employers to notify employees of the availability of unemployment compensation and permitting individuals to apply for unemployment compensation in at least two of the following ways-in-person, by phone, or online). The remainder of the grant would be reserved for states in which the number of unemployment compensation claims has increased by at least 10% over the same quarter in the prior calendar year. To receive access to the second portion of the grant, states must, among other things, make it easier for individuals to obtain unemployment compensation by waiving work search requirements and waiting periods. A copy of the law can be found here.

DOL Issues Guidance on the Families First Coronavirus Response Act 

The U.S. Department of Labor’s Wage and Hour Division (WHD) announced its first round of published guidance to provide information to employees and employers about how each will be able to take advantage of the protections and relief offered by the Families First Coronavirus Response Act (FFCRA) when it takes effect on April 1, 2020.

FFCRA will help the United States combat and defeat COVID-19 by giving all American businesses with fewer than 500 employees funds to provide employees with paid leave, either for the employee’s own health needs or to care for family members. The legislation will ensure that workers are not forced to choose between their paychecks and the public health measures needed to combat the virus while at the same time reimbursing businesses.

The guidance addresses critical questions, such as how an employer must count the number of their employees to determine coverage; how small businesses can obtain an exemption; how to count hours for part-time employees; and how to calculate the wages employees are entitled to under this law. This is just the first round of information and compliance assistance to come from WHD.

Families First Response Act: Questions and Answers

DOL Provides Second Guidance Questions and Answers

DOL Provides Third Guidance Questions and Answers

Fact Sheet for Employers

Fact Sheet for Employees


Wage and Hour Division, Department of Labor Workplace Poster

Where do I post this notice? Since most of my workforce is teleworking, where do I electronically “post” this notice?
Each covered employer must post a notice of the Families First Coronavirus Response Act (FFCRA) requirements in a conspicuous place on its premises. An employer may satisfy this requirement by emailing or direct mailing this notice to employees or posting this notice on an employee information internal or external website.

Do I have to post this notice in other languages that my employees speak? Where can I get the notice in other languages?
You are not required to post this notice in multiple languages, but the Department of Labor is working on translations.

Do I have to share this notice with recently laid-off individuals?
No, the FFCRA requirements explained on this notice apply only to current employees.

Do I have to share this notice with new job applicants?
No, the FFRCA requirements apply only to current employees. Employers are under no obligation to provide the notice of those requirements to prospective employees.

Do I have to give notice of the FFCRA requirements to new hires?
Yes, if you hire a job applicant, you must convey this notice to them, either by email, direct mail, or by posting this notice on the premises or on an employee information internal or external website.

If my state provides greater protections than the FFCRA, do I still have to post this notice?
Yes, all covered employers must post this notice regardless of whether their state requires greater protections. The employer must comply with both federal and state law.

I am a small business owner. Do I have to post this notice?
Yes. All employers covered by the paid sick leave and expanded family and medical leave provisions of the FFCRA (i.e., certain public sector employers and private sector employers with fewer than 500 employees) are required to post this notice.

How do I know if I have the most up-to-date notice? Will there be updates to this notice in the future?
The most recent version of this notice was issued on March 25, 2020. Check the Wage and Hour Division’s website or sign up for Key News Alerts to ensure that you remain current with all notice requirements: www.dol.gov/agencies/whd.

Our employees must report to our main office headquarters each morning and then go off to work at our different worksite locations. Do we have to post this notice at all of our different worksite locations?
The notice needs to be displayed in a conspicuous place where employees can see it. If they are able to see it at the main office, it is not necessary to display the notice at your different worksite locations.

Do I have to pay for notices?
No. To obtain notices free of charge, contact the Department’s Wage and Hour Division at 1-866-4-USWAGE (1-866-487-9243). Alternatively, you may download and print the notice yourself from https://www.dol.gov/agencies/whd/posters

I am running out of wall space. Can I put the required notices in a binder that I put on the wall?
No, you cannot put federal notices in a binder. Generally, employers must display federal notices in a conspicuous place where they are easily visible to all employees-the intended audience.

We have break rooms on each floor in our building. Do I have to post notices in each break room on each floor or can I just post them in the lunchroom?
If all of your employees regularly visit the lunchroom, then you can post all the required notices there. If not, then you can post the notices in the break rooms on each floor or in another location where they can easily be seen by employees on each floor.

Our company has many buildings. Our employees report directly to the building where they work, and there is no requirement that they first report to our main office or headquarters prior to commencing work. Do I have to post this notice in each of our buildings?
Yes. Where an employer has employees reporting directly to work in several different buildings, the employer must post all required federal notices in each building, even if the buildings are located in the same general vicinity (e.g., in an industrial park or on a campus).

The poster can be found here.


Many Employers Must Offer Paid Leave Under Coronavirus Relief Law

Here are the details from the Society for Human Resource Management (SHRM)


IRS Issues Tax Return Filing and Payment Relief — Updated March 24, 2020

internal revenue service building foundation

The Treasury Department and the Internal Revenue Service (IRS) announced special Federal income tax return filing and payment relief in response to the ongoing Coronavirus Disease 2019 (COVID-19) emergency in Notice 2020-18.

Released at the same time as the notice, the IRS answers frequently asked questions related to the relief provided for filing federal tax returns, paying estimated taxes, contributing to IRAs, HSAs, and receiving refunds.

These questions and answers will be updated periodically and are designed to be a flexible tool to communicate information to taxpayers and tax professionals in this changing environment. The answers to these questions provide responses to general inquiries and are not citable as legal authority. Accordingly, the Treasury Department and the IRS are continuing to consider additional IRB guidance on these issues addressed in these FAQs.

Click here for a copy of IRS Notice 2020-18 and FAQs.


Resources for small businesses

https://www.sba.gov/page/coronavirus-covid-19-small-business-guidance-loan-resources

https://sbdcmichigan.org/small-business-covid19/

https://www.detroitchamber.com/small-businesses-what-you-need-to-know-in-the-midst-of-covid-19/

https://sbdcmichigan.org/disaster-loan-help/


Additional relief available to Michigan businesses as loans or grants

The Michigan Economic Development Corporation (MEDC) offers a Michigan Small Business Relief Program, authorizing up to $10 million in small business grants and $10 million in small business loans for emergency relief to businesses directly impacted by the COVID-19 outbreak.  Details and how to apply can be found here.


I have questions not answered here.  What should I do?

Please feel free to contact us at info@mason-mcbride.com or call us directly at (248) 822-7170 to speak to our team to answer your questions specific to your particular situation.


DISCLAIMER

The information, examples and suggestions presented in this material have been developed from sources believed to be reliable, from a variety of sources including industry, regulatory and legislative. They should not be construed as legal or other professional advice.

This material is for illustrative purposes and is not intended to constitute a contract. This material is presented for educational purposes only.

Please consult your specific insurance contract for actual terms, coverages, amounts, conditions, and exclusions.

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