CORONAVIRUS (COVID-19) UPDATES

STEPS TO PREVENT ILLNESS:

There is currently no vaccine to prevent coronavirus disease 2019. THE BEST WAY TO PREVENT ILLNESS IS TO AVOID BEING EXPOSED TO THE VIRUS

The virus is thought to spread mainly from person to person.

* Between people who are in close contact with one another (within 6 feet)
* through respiratory droplets produced when an infected person coughs
or sneezes. These droplets can land in the mouths or noses of people who
are nearby or possibly be inhaled into the lungs.

TAKE STEPS TO PROTECT YOURSELF

Clean your hands often.

Wash your hands often with soap and water for at least 20 seconds especially after you have been in a public place, or after blowing your nose, coughing or sneezing.

If soap and water are not readily availabler, use a hand sanitizer that contains at least 60% alcohol. Cover all surfaces of your hands and rub them together until they feel dry.

Avoid touching your eyes, nose and mouth with unwashed hands.

Avoid close contact.

Avoid close contact with people who are sick. AND stay at least 6 feet apart when encountering another person.

Stay home if you’re sick.

Stay home if you are sick. If you need medical care, make sure to call ahead before you go to a doctor’s office or emergency room.

Cover coughs and sneezes.

Cover your mouth and nose with a tissue when you cough or sneeze or use the inside of your elbow. Throw used tissues in the trash and immediately wash your hands with soap and water for at least 20 seconds. If soap and water are not readily available, clean your hands with a hand sanitizer that contains at least 60% alcohol.

CORONAVIRUS AND TELADOC SERVICES

BENEFITS:

Coverage – Covers the employee and all family members, spouse, domestic partner and dependent children up to age 26.

Unlimited Calls to a Board-Certified Physician – 24 hours, 7 days a week 365 days a year, weekends and holidays

Options for Mental Health Services – Members over 18 can easily connect with mental health professionals 7 days a week to help overcome anxiety or other mental health issues.

No Co-pays – No cost at all for the calls. Co-pays usually discourage use. Only the low monthly premium.

Quick and Easy Implementation – Teladoc is offering businesses and organizations that are currently clients of theirs a quick start program for any employees not currently covered. They can be implemented in approximately 10-15 days.

Remote Implementation – All implementation can be done via online, no need for an in person meeting, etc. Very minimum effort on your part. We would need a census (you should already have) of an agreement.

Current coverage – Your current health insurance plan may already have it in place. Review the coverage and make sure your employees know they have it.

IRS RESPONSE TO COVID-19

  • Tax Day – July 15th The Treasury Department announced on March 21, 2020 that the federal income tax filing due date is automatically extended from April 15. 2020 to July 15, 2020.
  • Treasury, IRS and Labor announce plan to implement Coronavirus-related leave for worker and tax credits for small and midsize businesses to swiftly recover the cost of providing Coronavirus-related leave. On March 20, 2020, the U.S, treasury. IRS and Labor announced that small and midsize employers can begin taking advantage of two new refundable payroll tax credits designed to immediately and fully reimburse then, dollar for dollar for the cost of providing Coronavirus related leave to their employees.
  • IRS: High-deductible health plans can cover Coronavirus costs. The IRS on March 11, 2020 advised that high-deductible health plans (HDHPs) can pay for 2019 Novel Coronavirus (COVID-19) related testing and treatment, without jeopardizing their status.

Letter to Industry Addressing COVID-19

Commissioner Rosendale recommends several steps industry can take to ease the burden on consumers during this challenging time.

March 26, 2020

To all Insurance Companies across all lines of business, all Licensed Producers, Independent Adjusters, and Other Interested Parties:

Thank you in advance for your continued work to assist Montanans with their insurance needs during this uncertain and rapidly-changing time.

I am writing to provide several recommendations to help consumers as we all get through the COVID-19 pandemic together. With your assistance and flexibility, Montana consumers will be able to more easily navigate their financial and insurance situations over the next several days, weeks, and months.

I have been in touch with the American Property Casualty Insurance Association (APCIA). They have shared with me their messaging to their members and the general public, and have provided me with a wealth of information of the various steps their members are taking to ease consumer burdens during this time. I am glad to see many voluntary actions being taken, such as flexible payment plans, cancellation suspensions, and philanthropic aid.

Below are several recommendations to help Montanans during the COVID-19 situation. Please consider these recommendations based on their practicality, relevance, and impact to your unique business and individual customers. The below list is not exhaustive; be creative in problem solving for Montana consumers while maintaining your obligations and solvency for your customers.

  • Flexible payment solutions for families, individuals, and businesses; providing additional time to make payments; allowing grace periods to delay premium payments
  • Suspending premium billing for small businesses such as restaurants, bars, and others that have been shut down or had their operations severely reduced, for a specific number of days or billing cycles
  • Waiving insurance premium late fees and other fees for families, individuals, and businesses
  • Pausing cancellation of coverage for motorists due to temporary non-payment and policy expiration
  • Expediting/expanding automobile coverage to allow personal vehicles to be covered while delivering food, medicine, or other essential provisions for commercial purposes
  • Streamline administrative processes and paperwork to ease consumer burdens and facilitate continuous coverage

If there are any regulatory hurdles that are preventing or slowing your implementation of flexibility measures to aid Montana consumers, please let me know immediately so that I can evaluate those concerns.

Now is the time to be proactive. I will be sending a press release shortly outlining the contents of this memo to the general public, and asking Montana consumers to reach out to their respective insurance producers before any potential missed payments or defaults occur. I am making a similar ask of you: please reach out to your customers as soon as possible and tell them how you can assist them during this time, what flexible options you are making available, and what they can do to maintain insurance coverage and benefits with as few headaches as possible.


CARRIER’S RESPONSE TO THE CORONAVIRUS

MONTANA HEALTH CO-OP

We are all facing unprecedented times. We know many of you are facing challenges in maintaining business operations and staffing levels prior to this global disruption. The CO-OP wants to be here to support you and do anything we can to assist in easing the burdens of business owner in the short term. It is with that in mind that the CO-OP will be extending the option of group coverage up to 6 months through calendar year 2020, so long as premiums continue to be paid for employees that find themselves in the following situations:   Employees who are experiencing a reduction in work hours and not meeting current eligibility of work hours to be covered on a group health plan, Employees who have been laid off from their current employer, Employees who have been temporarily laid off and anticipate to be rehired in the future, allow a shortened waiting period for an employee to be added to the group employer health coverage through open enrollment for new or rehired employees by their respective employer.   To accommodate the above situations, employers will need to keep premiums paid to current and meet all other designated guidelines as a covered entity of the CO-OP. The CO-OP will continue to follow current grace period and cancellations policies for payment of premiums that are in place now which allow employers a reasonable time frame to stay in good standing.  Please do not hesitate to reach out directly if you have questions.  

Jeff Swingley Director of Sales Mountain Health CO-OP & Montana Health CO-OP

UNITED HERITAGE INSURANCE

United Heritage has been receiving questions pertaining to eligibility as we all navigate through the COVID-19 pandemic. Given the current environment we have identified ways to support our mutual clients for our Life, Disability, Accident, Critical Illness and Vision policies:
 Eligibility – As a result of COVID-19 pandemic we understand clients may have to unexpectedly reduce employee hours below the minimum hours defined in the certificate for eligibility. When that is the case, as an accommodation for a reduction in hours occurring on or after 3/1/2020, the group may elect to continue coverage for those employees through 4/30/2020, within the plan they were on prior to the reduction in hours, by continuing to pay all premium at the pre-reduction level, including employer-paid and employee-paid premium. We will continue to monitor the situation and communicate any changes as it becomes available.
 Layoffs & Leaves of Absence– As a result of COVID-19 pandemic we understand clients may have to place employees unexpectedly on a temporary unpaid leave, and their employee certificates may not include an applicable continuation provision. When that is the case, as an accommodation for leaves occurring on or after 3/1/2020, the policyholder may elect to continue coverage for those employees through 4/30/2020 by continuing to pay all premium, including employer-paid and employee-paid premium. We will continue to monitor the situation and communicate any changes as it becomes available.
 Premium – We are closely monitoring regulations regarding billing grace periods, specifically those states that have issued guidelines related to the COVID-19 pandemic. Each policy contains a grace period which allows for continued insurance coverage for a specific period of time. We will adhere to the policy and will continue to monitor for market and regulatory changes. We remain focused on our policyholders and are prepared to respond to their needs during this time. Please contact us for assistance.
United Heritage appreciates all that you and your teams do in support of your clients, our mutual clients. We are in this partnership together and we will be getting additional information sent out to our broker partners as updates become available. We are open, we are serving our clients, and we will work with you as we manage through this unprecedented time in our communities.

PACIFIC SOURCE


In this unprecedented time. We are trying to keep up with the rapidly changing environment due to COVID-19. We have set the following in place, effective TODAY and extending through June 30th.

Individual Plans

  • For plans purchased on the Exchange – PacificSource will follow CMS guidelines to determine eligibility.
  • For plans purchased direct – PacificSource will extend the premium grace period from 30 days to  60 days for March/April bills.
  • Reinstatements – For plans purchased on the Exchange and direct, PacificSource will extend the reinstatement period from 15 days to 30 days. Individuals will now have 30 days to make missed premium payment to be reinstated.

Small and Large Groups

  • PacificSource will extend the grace period from 30 days to 60 days for March and April bills.
  • Reinstatements – PacificSource will extend the reinstatement period from 15 days to 30 days. Groups termed for non-payment will now have 30 days to make the premium payment and be reinstated.
  • PacificSource will allow employers to pay for and keep furloughed workers covered by their plans.
  • PacificSource will eliminate the “minimum hours per week worked” requirement for an employee to be eligible for benefits.

UNUM

Unum is taking several steps to ensure we can support
customers and their employees through the coronavirus
(COVID-19) pandemic. As always, the health and safety of
our customers, colleagues, and communities remain our
top priority. Our business continuity program prepares us
to respond to disruptive events through robust planning,
regular testing, and constant monitoring – ensuring we
can continue to support you and your employees as the
situation progresses.
HOW IS UNUM RESPONDING TO CORONAVIRUS?
To minimize exposure to our employees and ensure stable
service experiences for you, we’ve taken steps to:
•• Restrict all employee business travel.
•• Require employees who travel international to selfquarantine
for 14 days.
•• Increase workplace sanitation and educate employees on
health and safety best practices.
•• Identify critical system needs and ensure they will remain
operational.
•• Test technology to confirm we can shift critical tasks to
other worksites and our remote workforce.
•• Enhance our remote-work capacity to handle a higher
volume of people working from home.
•• Account for variables in our planning, such as an increase
in the number of claims filed and the closure of banks
and post offices.
•• Seek input from vendors, state officials, and local
governments, and incorporate best practices from
external organizations.
IS AN INDIVIDUAL WHO IS QUARANTINED BUT
NOT SICK OR DIAGNOSED WITH CORONAVIRUS
CONSIDERED DISABLED?

Generally, we do not consider quarantined workers to
be disabled unless they have a medical condition that
results in restrictions and limitations that satisfy a policy’s
definition of disability.
ARE QUARANTINED INDIVIDUALS “IN ACTIVE
EMPLOYMENT”? DOES COVERAGE CONTINUE
DURING A QUARANTINE?

Generally, we would consider a quarantined individual to
be in “active employment” if the employee is quarantined
pursuant to a government order or if the employee’s
quarantine is an approved leave in accordance with the
leave provisions of the applicable policy.
We will consider individuals who self-quarantine to be in
active employment for a period of time consistent with the
quarantine period recommended by the Center for Disease
Control (currently 2 weeks).
An individual’s coverage will continue while they are
quarantined per these guidelines if premiums are paid.
WILL UNUM OFFER ANY CORONAVIRUS-RELATED
RIDERS OR ENHANCEMENTS TO STD AND AD&D?

We will be working with policyholders on a case by case
basis to consider solutions when requested. At this time we
have no products specific to coronavirus, but are reviewing
all available options for our customers.

WOULD UNUM BE WILLING TO OFFER ADDITIONAL
COVERAGE TO EMPLOYEES WORKING ON
CORONAVIRUS TEAMS OR TASK FORCES?

We recognize that our customers in the health care
provider industry in particular have a unique set of
considerations when thinking through coronavirus risks
and related benefit coverage for their employees. Unum
is committed to working with our customers to assess
their needs and develop appropriate coverage solutions.
We will evaluate each request of this nature for U.S.-based
coverage on a case-by-case basis, taking into account the
distinct characteristics of the customer and the related risk.
DO UNUM BENEFITS COVER COVID-19-RELATED
ILLNESSES?

Some of Unum’s products cover coronavirus-related claims,
and we will follow the provisions outlined in your policies
and service agreements to determine coverage – just like
we would for any other diagnosis.
While every claim and leave of absence is unique and will
be considered based on the facts of the case, we do have
some general guidelines to answer common questions
about how COVID-19 impacts your Unum benefits
coverage.
LEAVE SERVICES
Given current federal law, which is evolving in realtime,
generally, quarantined employees are not entitled
to FMLA unless they meet the definition of a serious
health condition. FMLA typically will not be applicable,
as quarantine itself does not qualify as a serious health
condition. The applicable regulations generally define
serious health condition as an illness, injury, impairment, or
physical or mental condition that involves inpatient care or
continuing treatment by a health care provider. However,
if a serious health condition develops from the underlying
condition for which the individual was quarantined, we
would then review to determine if FMLA is applicable. In
addition, we will consider applicable state leave laws and
any corporate leave policies currently administered by
Unum. Should federal leave law change, we will update this
guidance accordingly.
SHORT TERM DISABILITY PRODUCTS
(INDIVIDUAL AND GROUP)

•• Coronavirus coverage: If a person is diagnosed with
coronavirus, a claim for fully-insured STD benefits would
likely be payable after the elimination period if the
definition of disability has been met. Individuals who are
quarantined without a diagnosis and not sick generally
would not have a payable claim.
•• Administrative Services Only (ASO): While we generally
follow the same approach we use with fully-insured
STD customers, we will work with our ASO self-insured
customers to administer their plans in accordance with
their needs.
CRITICAL ILLNESS PRODUCTS
Coronavirus is not considered a covered condition under
our Critical Illness products except where ‘Infectious
Disease’ is noted as a payable benefit in the contract. In
such circumstances, the definition which generally includes
the requirement of a positive diagnosis and confinement
for a minimum of 14 consecutive days must be met.
AMERICANS WITH DISABILITIES ACT SERVICES
If a person is diagnosed with coronavirus, ADA services
would request and evaluate medical information to
determine if the severity of illness rises to the level
of disability under ADA or any state equivalent laws.
Individuals who are quarantined without a diagnosis and
not sick generally would not be considered disabled. In
addition, the EEOC has published guidance for employers
on specific workplace practices and inquiries related to
COVID-19 (https://www.eeoc.gov/eeoc/newsroom/wysk/
wysk_ada_rehabilitaion_act_coronavirus.cfm).
LONG TERM DISABILITY AND LIFE WAIVER OF
PREMIUM (INDIVIDUAL AND GROUP)

•• Coronavirus coverage: If a person is diagnosed with
coronavirus, a claim for fully-insured LTD and/or LWOP
benefits would likely be payable after the elimination
period if the definition of disability has been met. As
with STD, individuals who are quarantined but not sick
generally would not have a payable claim.
•• Administrative Services Only (ASO): While we generally
follow the same approach we use with fully-insured
STD customers, we will work with our ASO self-insured
customers to administer their plans in accordance with
their needs.
INDIVIDUAL DISABILITY INCOME PRODUCTS
While definitions of disability vary, IDI would likely approve
a claim filed by someone with a coronavirus diagnosis if the
definition of disability has been met. IDI elimination periods
generally extend beyond a quarantine period. As with other
products, individuals who are quarantined but not sick
generally would not have a payable claim.

LONG-TERM CARE PRODUCTS
A Long-Term Care claim filed by individual diagnosed with
coronavirus would likely be payable if they meet the policy
definition and they are receiving covered services. If a
claimant is quarantined and not receiving covered services,
no benefits would likely be payable.
ACCIDENT PRODUCTS
Accident products do not provide benefits for the diagnosis
or treatment of coronavirus except where the product
includes a Sickness Hospital Confinement Rider which
may provide benefits due to the confinement of a covered
sickness.
HOSPITAL INDEMNITY PRODUCTS
Admission/confinement due to a positive diagnosis of
coronavirus may be considered for eligible benefits
provided all other provisions of the policy are met. This
includes, but is not limited to, meeting the facility definition
to which the insured is admitted/confined.
LIFE INSURANCE PRODUCTS
Coronavirus is a covered illness for our group and voluntary
life insurance products. Benefits would be paid according
to policy provisions.
ACCIDENTAL DEATH & DISMEMBERMENT
PRODUCTS

Accidental Death & Dismemberment coverage does not
apply with a coronavirus diagnosis.
WORK-LIFE BALANCE EMPLOYEE ASSISTANCE
PROGRAM (EAP)

This service can help employees with managing anxiety
around this pandemic.

Toll-free 24/7 access:
• 1-800-854-1446
(multi-lingual)
• www.unum.com/lifebalance


WORLDWIDE EMERGENCY TRAVEL ASSISTANCE
When traveling, one phone call can connect employees and
their family members to medical, legal and other services
24/7, and can provide custom travel support during this
pandemic. It’s available with group Long Term and Short
Term Disability Insurance. It’s included with most of our
group Long Term Disability policies.

METLIFE

Life, Disability, Dental & Vision Administration: Are employees who were actively at work prior to a furlough, and enrolled for [Life, Disability, Dental or Vision] coverage, eligible for benefits while on furlough? We understand that the COVID-19 pandemic may require customers to unexpectedly furlough employees, and employee certificates may not include furloughs as an approved leave of absence.  If the certificate does not include furloughs as an approved leave of absence, as an accommodation for furloughs occurring on or after 3/1/2020, the policyholder may elect to continue to pay premium through 4/30/2020.  Should a furloughed employee for whom premium is paid become disabled under the terms of the certificate on or before 4/30/2020, the disability will be approved.  For purposes of Disability Benefits during this period, MetLife will utilize the higher of: (a) the employee’s gross salary or wages on his/her last day of Active Work before the Disability began; and (b) the employee’s most recent gross salary or wages before the furlough. For purposes of Life Insurance, MetLife will utilize the amount of insurance in effect on the employee on his/her last day of Active Work before the continuation of insurance due to a furlough/leave absence began. MetLife will continue to review the situation and will provide additional guidance as it becomes available.

DELTA DENTAL

For individuals who term coverage because of furlough/layoff due to the COVID-19 situation, we will waive benefit waiting periods for members laid-off and rehired within 6 months by the same employer.  When enrollees are rehired and re-enroll in the dental plan, please clarify they are being rehired after being furloughed/laid off due to the impact of COVID-19 to ensure the benefit waiting period is waived.

GUARDIAN

At this point, employees will be covered through the end of April if they are furloughed, as long as the premium is being paid for all lines of coverage with the exception of STD (Short-term disability) and LTD (Long-term disability). We may open that up for STD soon and also extend that time line, but as of right now that is our stance.

  We’re actively monitoring the coronavirus situation as it changes daily, and we continue to evaluate how to best serve our customers. Guardian recently announced a temporary accommodation to continue coverage for an employee who may normally lose benefit eligibility due to a change in work status.   We’re making two changes to this accommodation: It now applies to Short Term Disability, as well as our Dental, Vision, Accident and Cancer, Critical Illness, Hospital Indemnity, Life, Accidental Death and Dismemberment, Optional Life, and Optional Accidental Death and Dismemberment products.  
It will now extend through 6/30/2020.  


AMERITAS-

Ameritas is working around the clock to answer commonly asked
questions for our customers and business partners. We will update
the following list of questions and answers regularly. If your
question is not addressed, please contact your Ameritas
representative.
Your well-being is our top priority and we encourage you to take
care of your dental health needs. If you have concerns about your
coverage at the time of service, or there were changes to your
treatment plan because of the pandemic, we would like to assist
you with those concerns. Please submit your dental claims as
usual and include a brief explanation with those extenuating
circumstances. We will review each situation individually.
If you have a dental emergency, please visit your provider and
submit your claim accordingly.
If an employer has to terminate all employees for 60 days and
then rehire them, would the group coverage remain active?
The group would remain active with zero members for two months,
and then resume coverage after 60 days. Rates and plan benefits
would not change.
Will coverage terminate if the payment is late?
No. Ameritas will not mail any late payment notices during this
time, and we’ll work with customers to extend grace periods. We
are extending our premium grace period to 60 days while
continuing coverage and claims payment. Ameritas will adhere
to any state mandated premium grace periods as a temporary
exception to our policy during this time.
Will coverage continue if an employee was furloughed or
temporarily laid off?
For dental coverage an employer/employee has the option to do
what’s best for them:
• Option 1: If they terminate the coverage during this crisis and
send us the termination date, we would no longer charge premium
and claims payments would stop during this timeframe. When
employment resumes, they can reinstate the coverage and as long
as this is done within 12 months, their benefits (deductible,
maximums) will resume as if they’ve never left.
• Option 2: If they want to continue coverage, they can pay
premium via COBRA. In this scenario, claims payments continue
as normal and when they come back to work, they would resume
payroll deduction or employer contributions.
For vision coverage, some plans use a calendar year and others
are based on the date of service. If a member terminates vision
coverage (VSP, EyeMed or Vision Perfect) during a furlough
period and then reinstates that coverage within the plan year or
within 12 months, coverage would resume with the same plan
frequencies. If coverage is reinstated after 12 months or after the
plan year is complete, the plan would start over with new
frequencies based on the new effective date.
How long will this furlough policy continue?
This would last for the length of the crisis situation. We understand
that some employers could be in crisis mode long after the
coronavirus is contained. We will work with groups individually to
do what’s best for them.
Does the furlough policy pertain to all products?
This policy pertains to dental, vision, hearing, and LASIK
coverage.
If an employee’s hours are reduced to a level below the
Member Definition, can coverage be continued?
Yes. We understand that this will occur as employers are trying to
maintain their own service levels. We trust our policyholders and
know that they’re trying to do what’s best for their employees
during this time.
How long will coverage continue for employees whose hours
are reduced?
We understand that this crisis could last long after the coronavirus
is contained. We know that our policyholders are trying to do
what’s best for their employees and trust their judgement. If they
consider the member eligible for benefits, we will too.

What if employees take COBRA coverage upon termination?
If employees are terminated and want to continue with COBRA,
this continuation is available for as long as COBRA is allowed for a
termination – typically 18 months.
If enrollment is delayed, what can we do to ensure that those
who would have enrolled do not have any waiting periods or
eligibility hardships once they come back to work?
We would work with the employer and make employees eligible
when the employer makes them eligible, and not impose late
entrant penalties.
Will Ameritas extend timely claim filing by 60 days given the
current situation?
If your claim was not covered due to timely filing requirements,
please contact a customer service representative for review.
Does Ameritas cover teledentistry claims?
We will adjudicate claims the same as we do today for services
received in person in a traditional practice setting. Providers have
been advised through ADA guidance on how to submit claims
accordingly. Consideration of waiving frequency limits for
applicable services will be determined on a case-by-case basis.
What if a member has an emergency and can’t get in to see
the dentist they normally see?
We encourage our members to take care of their dental health
needs. Please submit the claim as usual with a statement
regarding your situation. We will be glad to review the claim on a
case-by-case basis. It is important our customers are not affected
by this time of uncertainty.
What if a child is maxing out in age at end of the month and
the dental office canceled their appointment?
We encourage our members to take care of their dental health
needs. Please submit the claim as usual with a statement
regarding your situation. We will be glad to review the claim on a
case-by-case basis. It is important our customers are not affected
by this time of uncertainty.
What if an employee has a tooth extracted during the time
they are furloughed or laid off, and therefore not covered, and
then they return to work and resume coverage?
We will treat the replacement of that tooth the same way we would
have had they been covered at the time the tooth was extracted. If
the member or provider submits the claim with an explanation that
the extraction was done during the furlough, we will make the
exception to process the claim provided that this a covered
procedure and the waiting periods have been met.
What if a member has paid a claim and wants to be
reimbursed, but the claim requires x-rays and charting and
the dental office is not open to provide this information?
Please have the employee contact our customer service
representatives to waive the request for additional information
when the dental office is closed.
What if a member or dependent is actively receiving
orthodontic treatment and the employee was furloughed or
temporarily laid off?
Please have the employee submit a statement with their next
orthodontic payment and we will restart the program and resume
payment on the treatment program.
If you have further questions about your coverage with
Ameritas:
Employers, please contact us at
group_assistants@ameritas.com.
Members, please contact us at group@ameritas.com.
And please include COVID in your email subject line. We’re here
to help you.
3.24.20


VSP VISION CARE-

          Our hearts go out to all of you as we navigate the impacts of the COVID-19 pandemic. From the way we work, to the way we interact with our family and friends, we’re all looking at the world a little differently. We want you to know that you can depend on VSP® Vision Care to be by your side during and after this rapidly evolving time. For more than 65 years, we have been focused on improving and safeguarding the well-being of our communities—from our clients and brokers, to our 89 million members, to our own employees. That focus on wellness extends to you now and in the future. To that end, we are working to create real-world answers and solutions that will help you adapt and adjust to current realities…and serve you as we come out of the uncertainty together. We are here for you. Here’s how:
We are here to serve you. Although our teams are primarily working remotely, your account teams are on the job for you. We’re working diligently to answer your questions and provide options that will assist you. We provide and maintain robust self-service tools on vsp.com, allowing for membership updates, accessing statements, and making payments. To access these tools, visit Manage Your Plan on vsp.com. We also offer extended customer service hours seven days a week to accommodate our clients’ and members’ needs in all U.S. time zones. Learn more about business solutions VSP members can still use their benefits. The need for clear vision doesn’t pause for pandemics. Members experiencing blurry vision, eye pain, injuries, or other changes in their vision should seek urgent eye care. In compliance with Centers for Disease Control and Prevention (CDC), state, and local mandates, in many parts of the country, vision services are limited to essential and emergency needs, members are encouraged to contact their VSP network doctor directly or our call center if a vision emergency arises.Members can utilize their benefits to reorder contact lenses and purchase new glasses. Members can contact their VSP network doctor or log in to eyeconic.com, VSP’s “always open” online store. We know the world around us is changing rapidly, and we empathize with all who are making difficult business decisions as a result of the COVID-19 pandemic. Your well-being, now and in the future, is our top priority. Please reach out to us with any questions. Clients with more than 1,000 lives covered: contact your VSP account representative Clients with fewer than 1,000 lives covered: 1.800.216.6248 Your Team at VSP Vision Care                    

Insurance coverage and COVID-19 at PRINCIPAL-

If someone is under quarantine for COVID-19, they don’t automatically have a disabling medical condition to satisfy the definition of disability under our policies. As with all claim submissions, the definition of disability and all other provisions outlined in the policy must be met.
Claims for COVID-19 will be evaluated the same as any other illness. As with all claims, that person must meet the definition of disability and all other provisions outlined in the policy.
our standard practice is to continue coverage until the end of the month. However, as an administrative exception due to impacts from COVID-19, any employees required to stay home on or after March 1, 2020, until April 30, 2020, may continue until May 30,2020, as long as the employer continues to pay premiums. If an employee tests positive for COVID-19, coverage will continue while they are ill, again, as long as the employer pays the premiums.
As an administrative exception due to the impacts from COVID-19, any employee with a reduced schedule on or after March 1, 2020 until April 30, 2020 will continue to be covered until May 31, 2020, provided the employer pays premiums. Premiums should be paid at the full-time rate in place prior to the reduction in hours.

Any employee laid off or furloughed on or after March 1, 2020 until April 30, 2020 may continue to be covered until May 31, 2020, if the employer continues to pay premiums. For employees whose coverage terminates due to layoff or furlough and are rehired within six months of the termination date, benefits are reinstated without a new hire waiting period.

Critical illness policies pay benefits when the person that’s insured is diagnosed with illnesses specified in his or her policy, and COVID-19 is not a specified illness under our policies. Principal will also pay the death benefit as long as the policy is in good standing (Premiums are paid and current). the policy covers death, regardless of the cause.* (*Subject to contractual terms of the policy and any applicable rider)
All coverage through Principal will remain active through May 31, 2020, if the employer continues to pay premiums.
Principal will reimburse for services performed via teledentistry, just as if the service was performed in a traditional office setting. The American Dental Association (ADA) is recommending that dentists focus on emergency care.

We also know that you may be feeling overwhelmed and anxious. As a customer with benefits through your employer, you have access to the Employee Assistance Program (EAP). Currently, Principal and Magellan are extending telephonic EAP support during the COVID-19 crisis. Contact Magellan Healthcare 24/7 at 800-450-1327 for free, confidential consultation services.

Principal also understands that this might be a financially challenging time. So we’re extending grace periods to 60 days for monthly bills through June 1, 2020.

Plus, we’re actively monitoring grace period changes at a state level and will implement those requirements that have a grace period longer than 60 days.

This is a rapidly changing situation. We’ll continue to monitor and adjust information, so check back for updates.

Rate stability in unprecedented times

The coronavirus (COVID-19) pandemic has created unprecedented times. And like many of you, we’re closely monitoring the spread and impact. Our thoughts go out to those who have been directly affected by the virus in their communities, health care workers who are on the frontlines, and businesses who have had to temporarily close. 

We want to help. One way we can do that is to remove renewal conversations that are going on right now. For employers with less than 500 employees and policy anniversary dates of May 1, 2020 through Aug. 15, 2020, there won’t be any rate increases.*

PRINCIPAL – THE CARES ACT: WHAT YOU NEED TO KNOW!

As you may have heard, Congress has passed and the President has signed into law the Coronavirus Aid, Relief, and Economic Security Act (commonly known as the CARES Act). The CARES Act will provide necessary relief to America’s families and businesses as we all manage the COVID-19 health crisis and resulting economic turmoil.

While this is good news, there’s a lot of information within this legislation to unpack.

We’ve reviewed the legislation and highlighted some of the impacts the CARES Act may have on IRAs and retirement plans, from what we know today.

Withdrawal changes Tax-favored withdrawal, penalty-free, coronavirus-related distributions up to $100,000 between Jan. 1-Dec. 31, 2020.* Repayment of coronavirus-related distributions permitted within three years of taking the distribution. Coronavirus-related distributions may be included in individuals’ taxable income over a three-year period. The mandatory 20% withholding will not apply. RMD Changes Required Minimum Distributions (RMDs) may be waived in 2020 (including those who had not yet received their first distribution if they turned 70 ½ in 2019). A plan or IRA beneficiary receiving distributions over a 5-year period will be able to waive the distribution for 2020. Loan changesPlan loan dollar limits will be temporarily increased to the lesser of $100,000 or 100% of the participant’s vested balance (applies to loans taken within 180 days of the enactment).** One-year delay for loan repayments due in 2020 with subsequent payments adjusted to take into account the delay. Loan durations (including the 5-year maximum) may also be disregarded during this period, if payments are delayed. Plan changes Plan amendments for coronavirus-related distributions, RMD waivers, and increased loan limits—all of which are optional—would be required by the last day of the plan year beginning on or after Jan. 1, 2022 (with an additional two years for government plans). Defined benefit changes Single-employer pension plan funding relief by delaying minimum required contributions to Jan. 1, 2021. Plan sponsors may elect to treat the plan’s funding percentage (AFTAP or adjusted funding target attainment percentage) for plan years which include the 2020 calendar year the same as the funding percentage for the last plan year ending before Jan. 1, 2020 (with interest applying to late contributions). This is just quick look at some top-level changes, to help you answer questions and guide discussions in the days to come. Look for more detailed communications from us coming your way next week. In the interim, be sure to visit and bookmark our managing market uncertainty landing page for the latest news and information from Principal.

We’re committed to continuing to work together to help our customers make informed and empowered decisions during this challenging time. Please doesn’t hesitate to reach out with questions.


COVID-19 tax-favored withdrawal option
The COVID-19 tax-favored withdrawal option allows plan sponsors to add an optional form of withdrawal for their participants who are impacted by COVID-19.

What does it allow?
If a COVID-19 withdrawal is taken, the 10% penalty tax does not apply. Standard 20% withholding is reduced to 10% withholding. Income taxes for the distribution can be spread over 3 years. Maximum amount available for a participant to withdraw is $100,000, and participants may be permitted to recontribute the amount within 3 years (as a rollover) without regard to contribution limits. Self-certification is available—participants can certify they have been affected by COVID-19 and are eligible for a distribution. In order to qualify, participants must certify they have adverse financial consequences from the COVID-19 pandemic or they, their spouse or dependent have been diagnosed with COVID-19 or SARS-CoV-2.*This is available between now and Dec. 31, 2020.   Here’s what we’re doing
Plan sponsors will receive a CARES Act Authorization form to eSign under My Documents on the employer website if they are interested in adding the COVID-19 tax-favored withdrawal option to their plan. And, we’ll provide them with simple instructions on how they can let their participants know it’s available, once they agree. Rest assured, we have procedures in place to process withdrawal requests quickly once we know they want it added.

What else does the CARES Act Authorization provide?
When clients eSign the CARES Act Authorization, they will also be adding the following provisions to their plan.

Loans
IRS plan loan limits for participants requesting new loans have been increased to 100% of vested account balance, up to $100,000, for 180 days, beginning March 27, 2020.** Plan loan payments due between now and Dec. 31, 2020 are delayed for one year, with this time period disregarded from the loan’s term, and subsequent payment due dates are adjusted accordingly (with interest). This only applies to plans that already have loan provisions.  
RMDs
There is a temporary waiver of the RMD rules for distributions required in 2020 for defined contribution plans. An additional year is allowed for beneficiaries to complete their distributions if they are taking distributions under the 5-year rule. If clients don’t sign the CARES Act Authorization, the RMD waiver will still be added to their plan. Does my client have other options?
If they don’t want to eSign the CARES Act Authorization, they can contact us to discuss further options.

CARES Act: DB funding
The CARES Act also provides the following: Single-employer defined benefit plan sponsors are permitted to delay any contributions due during calendar 2020 until Jan. 1, 2021. Deferred contributions accrue interest at the funding effective rate until paid. Benefit restriction rules impacting accelerated distributions (including a payment made in a lump sum) for plans subject to ERISA have also been relaxed, permitting plan sponsors to lock in their adjusted funding target attainment percentage (AFTAP) from the last plan year, ending before Jan. 1, 2020. We’ll be reaching out to clients with DB plans with more specifics in the coming weeks.

What if a client is working with a TPA or an outside plan document provider?  
We’re directing those clients to either contact their TPA, or their outside plan document provider, to determine the impact the CARES Act could have on their plan.  
 

BLUE CROSS / BLUE SHIELD-

   
    COVID-19 Update: Telehealth and Treatment Cost-Share Waivers


June 25, 2020
We continue to monitor the COVID-19 pandemic and are committed to helping our employer customers and members stay informed. We have updates to some of our coverage dates. As always, members should call the number on their ID card for answers to their specific benefit questions.
Initiative
Effective Date
Projected End Date
COVID-19 Testing
3/7/20
Cost-share waiver ends with the end of Health and Human Services (HHS) public health emergency
COVID-19 Testing-related visits
3/18/20
Cost-share waiver ends with the end of HHS public health emergency
Telehealth/Telemedicine
3/18/20
Cost-share waiver extended through 7/31/20*

For Medicare (not Part D) and Medicare Supplement plans, cost-share waiver extended through 12/31/20*
COVID-19 Treatment
4/1/20
Cost-share waiver ends 6/30/20
Interfacility Transfer
4/1/20
Ended 5/15/20
Prior Authorization extended on previously approved elective surgeries, procedures, therapies and behavioral health services**
Services scheduled between 1/1/20 and 6/30/20
12/31/20
Chest CT Scan
3/2/20
End of HHS public health emergency
*Date change/extension
**Behavioral Health services included in this extension.

As we let you know in April, self-funded customers (ASO) who aligned with our decisions for fully insured members would continue that alignment unless we were notified. We will suspend the cost-share waiver for COVID-19 treatment as of June 30, 2020, and extend the cost-share waiver for COVID – 19 treatment as of June 30, 2020, and extend the cost-share for telehealth through July 31, 2020.   bcbsmt.com  

TRUSTMARK-

IMPORTANT UPDATE! Benefit Changes Due to the Coronavirus
As the situation with the coronavirus (COVID-19) continues to
evolve, we have been proactive in announcing benefit changes
being made to self-funded group major medical benefit plan
designs (Trustmark HealthyChoicesSM, Trustmark HealthyEdgeSM and
Trustmark Healthy Incentives® plan designs) administered by Star
Marketing & Administration, Inc.
NEW! On Wednesday, March 18, 2020, a new federal law was
enacted, requiring coverage of testing for the coronavirus without
any cost sharing, prior authorization or other medical
management requirements.
President Donald Trump signed the Families First Coronavirus
Response Act, effective March 18, 2020, through Dec. 31, 2020,
which requires1 the following:
 Self-funded ERISA and church group major medical benefit
plans must cover testing for the coronavirus without cost
sharing, i.e., deductible, copay or coinsurance.
 Prior authorization or other medical management
requirements, such as medical necessity determinations and
out-of-network penalties, must not be imposed.
 The mandates apply to items and services furnished during a
visit at healthcare providers offices, urgent care centers,
emergency rooms , or via telehealth consultations (whether
by Teladoc® or another provider) that result in an order for or
administration of a test for the diagnosis of COVID-19.

This section of the law does not apply to federal or other
governmental benefit plans.
In addition to mandated benefit changes from the new federal
law, we previously announced telemedicine benefit changes to
major medical benefit plan designs administered by Star
Marketing & Administration, Inc.:
 Teladoc®: The consult fee for Teladoc telemedicine services
will be $0 through June 30, 2020. Teladoc provides covered
employees and their dependents with access to a U.S. boardcertified
doctor through the convenience of phone and
video consults for non-urgent care. In 2019, Teladoc was
ranked #1 in telehealth by J.D. Power.1 We announced this
change on March 13, 2020.
 Claims for virtual care/telemedicine visits with any non-
Teladoc doctor, such as your primary care physician: Except
for the testing mandate as explained above, these claims will
be processed as a physician office visit in accordance with
your plan’s provisions. Copays or deductibles will apply, if
applicable. This benefit change was announced in a
notification you should have received by March 18, 2020, and
is valid through June 30, 2020.

Telehealth Services and FAQ Update

At National General Benefits Solutions, we continue to monitor the COVID-19 outbreak and will provide you with updates as they are available.

Given that COVID-19 is a communicable disease, many physician practices and health care provider systems are launching alternative telehealth-based means to consult with doctors and nurses. The following updates will ensure plan members have access to the telehealth services they need to help stop the spread of COVID-19.

Telehealth services and FAQ update. All claims submitted with the place-of-service code “02” (telehealth) will be considered according to the plan benefits. Any claim with the place-of-service code “02” (telehealth) that is related to diagnostic testing for COVID-19 will have all member cost sharing waived. Plan members will not be subject to deductibles, copays, or coinsurance for telehealth virtual visits that are part of diagnostic testing for COVID-19. Plans with Teladoc®. If a Plan includes Teladoc for members and has a consultation fee, any applicable Teladoc consultation fees will be waived for the member. Plan members will not have to pay a consultation fee for Teladoc services. The consultation fee will be submitted as a fee to the Plan (payable from the claims account). The waiver of the Teladoc member cost sharing is in effect through the end of June 2020. Today, we sent this updated information and updated FAQ to all active groups.

MUST-

We are closely monitoring activity around the Novel Coronavirus (COVID-19) and its impact on our members, our employees and the communities we serve. While the COVID-19 situation is ever-changing, our commitment to our customers remains the same. We are constantly working on their behalf and will continue to review and process ancillary insurance claims on an individual, claim-by-claim basis—just as we have always done. Our ancillary coverages include life, short- and long-term disability, accident, critical illness, vision and dental. Coronavirus Support and Resources Hotline1 To provide additional support and peace of mind, we are now offering a special Support and Resources Hotline at 1-844-244-7657. All of our ancillary clients can utilize this new Employee Assistance Hotline from ComPsych®, at no extra charge. The Impact of Quarantine on a Disability Claim For disability lines of coverage, a quarantine, in and of itself, would not necessarily result in a claim being approved. The definition of disability requirements in the certificate of insurance are applicable. Business Resiliency Program Our Business Resiliency Program is designed to ensure operational resiliency by protecting our business processes and minimizing the impact of disruptions to our customers and business partners. Our program includes proactive work groups that address potential operational impacts and continuity, human resources matters, communications and customer support. Through this program, we are taking extra precautions to ensure an uninterrupted service experience for our customers. Coronavirus Support and Resources Hotline For additional support and resources, call our hotline toll-free at 1-844-244-7657.

HEATH EQUITY EMPLOYER SERVICES


The Coronavirus Aid, Relief, and Economic Security Act (CARES Act) signed into law today contains important provisions that will affect HSAs, HRAs and FSAs.

Effective immediately: HSA-qualified health plans can now cover telehealth and other remote care service expenses below the HDHP statutory deductible limit, or at no or low-cost sharing, without affecting an account holder’s ability to continue contributing to their HSA. This provision will last until December 31, 2021. Over-the-counter drugs and medicines can be paid for or reimbursed through an FSA, HRA or HSA without a doctor’s prescription. Menstrual care products are now considered a qualified medical expense and are eligible for payment or reimbursement through an FSA, HRA or HSA. All expenses incurred after December 31, 2019 qualify, and the provision has no expiration date. Right now, our team is working to: Update health care plan eligible expense lists as appropriate. Develop a plan amendment template to address these changes. Communicate with your team to help them take advantage of these changes. If you have questions, don’t hesitate to reach out. As always, we’re here for you.



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