Every business is struggling with how to retain their employees and also how to treat their health insurance.
What we have outlined below oversimplifies it, but is intended to give you a general sense of how insurance companies are addressing the most pressing concerns around the COVID-19 outbreak we have been experiencing the past month.
Are carriers granting premium extensions or extending grace periods for employee benefit plans?
Not yet and we are not anticipating. Insurance companies are seeing unprecedented usage (claims) and have not announced any formal extension of ordinary 30-day grace periods. Some carriers are suggesting employers write and request individual consideration. Keeping employees covered, even those furloughed, is critical for everyone. With the forthcoming Paycheck Protection Program (PPP), companies will likely be able to get forgivable loans (which will include 8 weeks of payroll INCLUDING health insurance), so with the availability of these loans and capital, employers should be able to remit premiums.
Patients who are hospitalized are consuming hundreds of thousands, if not millions of dollars of healthcare expenses. Unlike a building, where unpaid rent won’t weaken the structure or integrity of the building itself, loss of premium revenue atop massive reduction in revenues could potentially undermine the stability of insurers. Pay your health insurance premiums at all costs – these insurance companies just might be part of saving our lives.
Will carriers allow employees who are NOT actively at work, FMLA (Families First), those who drop below full-time status, or are otherwise furloughed, to remain on the health insurance plan?
For the most part, yes! Each carrier has announced a relaxed “actively at work” provision allowing employees who are otherwise not working to remain under plans for some period. Of course, employers should be addressing with their staff their intent and providing proper notice for any layoffs or leaves and complying with the Families First Act.
If employees are laid off and later hired, will the new hire waiting period be waived?
In general, most carriers will allow employers to adapt their policies to accommodate this unprecedented time. Here is what each has already declared:
- Aetna – Yes, through July 31, 2020
- Anthem – Yes, if rehired by May 31, 2020
- Blue Shield – Yes, if rehired within 6 months
- CIGNA – Unknown
- Kaiser – Will allow each client to define their waiting period
- United Healthcare – Yes
Will the carriers allow mid-year benefit changes at the employer level? At the employee level?
While this seems appealing, adapting a change in benefits during a period of chaos and where communication with eligible participants might be hard, is not recommended. That being said, here is what each major carrier is saying they will allow:
- Aetna – Yes, by July 31, 2020
- Anthem – Unknown
- Blue Shield – Yes, a one-time, mid-year exception
- CIGNA – Unknown
- Kaiser – Must be made by May 31, 2020
- United Healthcare – Yes, a one-time, mid-year exception
Are carriers offering a Special Open Enrollment period for employees who previously waived the coverage to join the plan?
For the most part, yes. This creates a dilemma for employers who may be seeking to minimize participant enrollment and the outlay associated with each employee on the plan. However, for someone who wants to open their enrollment, here is what each major carrier is allowing:
- Aetna – Not at this time
- Anthem – Special enrollment window through April 3, 2020
- Blue Shield – Special enrollment window
- CIGNA – Unknown
- Kaiser – Special enrollment window through April 3, 2020
- United Healthcare -Special enrollment window through April 6, 2020
Are carriers waiving the co-pay for Telemedicine or any other employee responsibilities for deductibles and/or co-insurance?
Universally YES. In fact, this period will spark the growth of telemedicine as a faster, more cost-effective and immediate way for people to receive healthcare advise and guidance.
- Aetna – Waiving cost share for telemedicine and cost share for COVID-19
- Anthem – Waive cost share for telemedicine
- Blue Shield – Waiving cost share for telemedicine
- CIGNA – Waiving cost share for telemedicine and cost share for COVID-19
- Kaiser – Waiving cost share for telemedicine
- UnitedHealthcare – Waiving cost share for telemedicine
Please keep in mind that everything is subject to change in a moment, and small/large group pools may dictate exactly what, when, and how things will happen. Reach out to your dedicated account executive at CorpStrat for guidance.
