COVID-19 Topics of Concern

All businesses are experiencing changes because of COVID-19. Businesses of all sizes are closing to the public and most will experience reductions in payroll and sales. And, of course, almost every business will experience some form of downsizing.

Whatever it is that your business is doing the below are resources related to Employee Benefits from The Richards Group and our Partners:

COVID-19 Testing: COVID-19 Testing, Treatment and Billing

The Centers for Medicare & Medicaid Services (CMS) recently added a new procedure code for COVID-19 and insurers will be configuring plans to add the code to the diagnostic testing benefit and waiving any member cost-sharing. This also will apply for all medically necessary COVID-19 testing, treatment, counseling and vaccinations (should they become available) at in-network doctor’s offices, urgent care centers, telemedicine visits or emergency rooms without the requirement of prior authorization. Coverage for inpatient treatment will typically follow the benefits of the member’s plan. Please check with your Insurer or call your TRG Team for exact benefits related to your company plan.


COVID-19, IRS Ruling related to HDHPs and HSAs: Released 3.11.2020

Due to the unprecedented public health emergency posed by COVID-19, and the need to eliminate potential administrative and financial barriers to testing for and treatment of COVID-19, a health plan that otherwise satisfies the requirements to be an HDHP under section 223(c)(2)(A) will not fail to be an HDHP merely because the health plan provides medical care services and items purchased related to testing for and treatment of COVID-19 prior to the satisfaction of the applicable minimum deductible. As a result, the individuals covered by such a plan will not fail to be eligible individuals under section 223(c)(1) merely because of the provision of those health benefits for testing and treatment of COVID-19.

Source: https://www.irs.gov/pub/irs-drop/n-20-15.pdf

TeleMedicine Resources:

Your health insurance plan usually has a Telemedicine Partner imbedded in your plan. Please contact your Health Insurer or your TRG Team for details. The below are links to the various providers:

Pharmacy Benefits:

Prescription coverage generally has not changed due to COVID-19. Many of the PBMs are allowing early refills of maintenance medications and encouraging 90-day supply to limit public exposure. Be sure to check with your PBM or your TRG Team should you have any questions or concerns.

Short Term Disability:

Generally, insurers will treat the COVID-19 condition the same as any other condition. To evaluate the medical necessity of leave, insurers will require an attending physician statement and medical records if needed for STD and medical certification for FMLA. In the event this is not possible, insurers will evaluate each circumstance on a case by case basis. Be sure to check with your Insurer or your TRG Team.

Things to think about or reasons to call your TRG Team:

Quarantine

  • Do you have a policy in place?

  • Is the leave paid time off, sick time, STD, FMLA?

  • How can we be assisting employees with compliance to quarantine requests?

 Furloughs and Layoffs

  • Pay continuation? Benefits continuation? Benefits contribution collection challenges? Policies? Stop Loss Insurance? COBRA? Will you need a plan amendment if you are self-funded?

Work from home

  • Do you have a policy in place?

Conferences and Travel

  • What actions are you taking to limit exposure to employees?

  • Are you limiting attendance to conferences?

  • Are you restricting business travel?

  • Are you monitoring or requesting employees that travel for leisure to self-quarantine before returning to work?

Schools

  • Employees with children in K-12 may need time off if schools are closed and/or child care is interrupted – is there a plan of action in place for this?

  • Employees with College Students may need time off to pick their children up if campuses close – do you have a policy/plan for this?