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Breaking: Senate Passes New Pandemic Relief Package

Breaking: Senate Passes New Pandemic Relief Package

On Tuesday, The Senate passed a $484 billion new relief package which will now head to the House for a vote on Thursday. Assuming House passage, the President is expected to sign the bill by the end of the week. 

 

  • Some of the items in the new package include but are not limited to: $310 billion for the Paycheck Protection Program (PPP), which ran out of funds late last week
  • $60 billion is set aside for small businesses who do not have access to large financial institutions, to be divided between lenders with less than $10 billion in assets and those with $10-$50 billion
  • $50 billion for SBA Economic Impact Disaster Loan (EIDL) program
  • $75 billion for hospitals
  • $25 billion for COVID-19 tests to be divided among federal, state, and local governments, with a requirement for a national testing strategy
  • Fixes to previous COVID-19 relief measures, including giving states and localities additional flexibility to use funds allocated to address lost revenues
A summary of the SBA provisions can be found here. A summary of the health provisions for hospitals and testing can be found here. 

 

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NJ Emergency Grace Period for Insurance Premiums

Guidance Follows Executive Order; Requires Emergency Grace Period of at Least 60 Days For Health Insurance Policy Holders & at Least 90 Days for Auto, Homeowners, Renters and Life Insurance Policy Holders

TRENTON — The New Jersey Department of Banking and Insurance today directed insurers to provide financial relief to residents and businesses, as New Jerseyans suffer financial hardship due to the COVID-19 pandemic. The guidance issued to regulated entities follows Executive Order 123 signed yesterday by Governor Phil Murphy extending grace periods during which certain insurance companies, including health insurers, life insurers, and property and casualty insurers, will not be able to cancel policies for nonpayment of premiums.

The executive order requires a minimum 60-day grace period for health and dental insurance policies, and a minimum 90-day grace period for life insurance, insurance premium-financing arrangements, and property and casualty insurance, which includes auto, homeowners, and renters insurance. 

Following the Executive Order, the Department directed health and dental insurance carriers in the individual market, small group and large group markets to provide a grace period for premium payments of at least 60 days. The department directed issuers of life insurance policies, property and casualty policies and insurance premium finance companies to provide a grace period for payments of at least 90 days. Consumers must contact their insurance company to take advantage of the emergency grace period and to discuss options to pay their premiums over time after the grace period ends.       

“We know that many New Jerseyans are facing financial hardship due to the unprecedented COVID-19 emergency. These actions will allow residents and businesses a grace period on premium payments for health insurance policies, as well as homeowners, renters, life and auto insurance. I want to thank Governor Murphy for his steadfast commitment to ensuring New Jerseyans continue to be protected by their insurance policies during this period, and that they receive the financial relief that they need,” said Department of Banking and Insurance Commissioner Marlene Caride. “I also want to thank the industry for providing financial options to policy holders that will ensure they maintain coverage, and for working in cooperation with the department as we implement these measures.”       

The Department of Banking and Insurance is directing carriers in the individual, small group and large group health insurance markets to:

  • Provide a 60-day grace period to pay insurance premiums and continue paying claims during this period; allow policyholders to amortize any unpaid payments over the remaining policy period (for example, if six months are remaining, the policy holder must be given the option to pay the unpaid premium in six installments in addition to the regular monthly premium);
  • Provide those with individual health plans obtained through the federal Marketplace, and receive subsidies, up to a 60-day grace period with claims paid and additional flexibility;
    Waive late payment and fees otherwise due, and not report late payments to credit reporting agencies;
  • Refrain from cancelling any policy or contract for nonpayment during the emergency grace periods, and not seek recoupment from any policyholder for any claims incurred during this emergency grace period; and 
  • Waive certain rules that as a result of the COVID-19 emergency could serve as a barrier to coverage for employees and employers.

    The Department of Banking and Insurance is directing property and casualty carriers to:

  • Provide a 90-day grace period to pay insurance premiums and continue paying claims during this period; allow policy holders to pay premiums not paid during the 90-day period over the remainder of the current policy term or in up to 12 months, whichever is longer;

     

  • Waive late payment fees otherwise due, and not report late payments to credit rating agencies;
  • Ensure that late payments during the 90-day period are not considered in any future premium calculations at any time (i.e. applicable late payments should not be counted for any rating, pricing, tiering attributes, etc.); and

     

  • Permit the grace period to be applied to all installment payments, including renewal down payments, provided that the insured provides notice to the insurer that they wish to continue coverage. 

    The Department of Banking and Insurance is directing life insurance carriers to:

  • Provide at least a 90-day grace period to policyholders or certificate holders to pay life insurance and annuity contracts premiums; allow premiums not paid during the 90-day period to be paid over the course of the following year in up to 12 equal installments;

     

  • Waive late payment fees otherwise due, including any interest permitted, and refrain from reporting late payments to credit rating agencies, during the 90-day period; and

     

  • Extend to 90 days the period to exercise policyholder and contract holder rights and benefits under life insurance and annuity contracts.

The guidance also directs carriers issuing Medicare Supplement plans and insurance premium finance companies to provide grace periods and repayment over a period of time. The Department directed all carriers to, in addition to posting information on their websites, provide each policyholder with an easily readable written description of the terms of the extended grace period offered pursuant to the Department’s guidance. 

 Resource: 

Bulletin – Health Insurance – Individual Market
•   Bulletin – Health Insurance – Small Employer Market
•   Bulletin – Health Insurance – Large Employer Market
•   Bulletin – Health Insurance – Medicare Supplement
•   Bulletin – Property and Casualty Insurance
•   Bulletin – Life Insurance

 

 

This document is designed to highlight various employee benefit matters of general interest to our readers. You should not act or rely on any information contained herein without seeking the advice of an attorney or tax professional.

Learn how a Private Exchange and our PEO Partnership can help your group please contact us at info@medicalsolutionscorp.com or (855)667-4621.

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NJ Expands Disability and Leave Benefits COVID-19

On March 26, 2020, New Jersey Governor Murphy signed legislation that expands the Temporary Disability Benefits (TDB) and Family Leave Insurance (FLI) programs effective immediately. The law also provides for job protection under the New Jersey Family Leave Act (NJFLA) and expands the Earned Sick Leave Law.

Temporary Disability Benefits and Family Leave Insurance Programs

The law expands the definition of a “serious health condition” in response to the COVID-19 pandemic to include an illness caused by a public health emergency. Workers now have access to TDB and FLI if they are unable to work because they are diagnosed with or suspected of exposure to a communicable disease or they are taking care of a family member in the same situation. The bill does not specifically refer to COVID-19, therefore, this expansion applies to COVID-19 and any public health emergencies declared by the Governor or Commissioner of Health or other public health authority. 

The bill eliminates the current one-week waiting period for temporary disability benefits for public health emergency related cases. 

Earned Sick Leave

New Jersey’s Earned Sick Leave (“ESLL”) laws are expanded to allow the use of earned sick time for quarantine or isolation recommended or ordered by a health care provider or public health official as a result of suspected exposure to a communicable disease or to care for a family under the same situation. 

Family Leave Act

The legislation modifies New Jersey’s Family Leave Act  so that the rights to reinstatement to employment provided also apply to those taking leaves for public health emergencies as provided for in the law. 

Employer Action

Employers should review their leave policies to ensure compliance with the new guidance.

 

This document is designed to highlight various employee benefit matters of general interest to our readers. You should not act or rely on any information contained herein without seeking the advice of an attorney or tax professional.

Learn how a Private Exchange and our PEO Partnership can help your group please contact us at info@medicalsolutionscorp.com or (855)667-4621.

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President Signs $2.3 Trillion Stimulus CARES Act

President Signs $2.3 Trillion Stimulus CARES Act

President Signs $2.3 Trillion Stimulus CARES Act

Visualization of the CARES ActPresident Donald Trump signed a $2 trillion bipartisan stimulus package Friday that is intended to address the threat of economic disaster posed by the coronavirus pandemic.

The largest stimulus in U.S. history stimulus package aimed at resuscitating the economy following several weeks of severe, acute economic downturn.  Senate and House passed the bill unanimously after a week. The following are the healthcare related provisions:

Hospitals

Hospitals will receive the $100 billion in federal assistance they initially requested be in the FFCRA along with a 20 percent bump in Medicare payments for treating COVID-19 patients. Experts expect rural hospitals to be hit especially hard during this pandemic, since they already operate on thin margins with limited staff.

Insurance Companies

Unlike the providers, insurers were not so lucky. Carriers requested an emergency fund to offset losses from the pandemic, including premium subsidies to help fund temporary COBRA coverage, but received nothing.

The bill expands coverage beyond what was in last week’s Families First bill by requiring health insurers to pay for coronavirus testing beyond those that are FDA-approved to include those provided by labs, state-developed tests, and any other tests approved by HHS.

Telehealth Expanded to HSA (Health Savings Accounts)

Accessibility for telehealth is also expanded. High deductible health plans with HSAs may now allow pre-deductible coverage for telehealth and other remote services, as well as allowing the use of HSAs for the purchase of over-the-counter medications without a prescription. In the past, the HSA Deductibel would have to first be met.

OTC items bought with pre-tax funds

After the Affordable Care Act, over-the-counter (OTC) drugs and medicines required a prescription in order to be eligible for reimbursement from an HSA, FSA or HRA. The CARES Act would allow individuals enrolled in these pre-tax accounts to pay for OTC drugs and medicines without a prescription. This action helps to reduce additional strain from an already overwhelmed healthcare system. This is a permanent chang

Surprise Bills

Very limited action was also taken to address surprise medical bills. Under the CARES Act, all health insurance plans would reimburse a COVID-19 test provider at the in-network rate put in place prior to the breakout. If the provider is out of network, the health plan is to fully reimburse the provider based on the provider’s own “cash price” which must be made publically available while the public health emergency is still declared. Providers that do not post their test price publically could be fined up to $300 a day. States like NYS in 2015 and NJ in 2018 have already passed Surprise Medical Bill Laws.

NYS

Will the Empire State see relief with the passage of the CARES Act? Governor Cuomo is not so sure, claiming that the $3.8 billion New York will receive is “a drop in the bucket as to need,” and that a previous House bill would have given his state $17 billion. Cuomo’s budget office predicted on Tuesday that state revenue losses could be as high as $15 billion.

Additionally, NYS Department of Labor received over one million calls from recently unemployed individuals in a single week, while the country as a whole reported 3.3 million jobs lost. The governor had already implemented several executive orders and moratoriums to provide relief for New Yorkers, including a 90-day pause on evictions as well as a halt on both medical debt and student loan debt collection. This week, the governor announced that utility companies will postpone rate increases that were set to go into effect on April 1.

State Funding

The bill also provides $150 billion for state and local governments, as states quickly burn through their own funding. Several states anticipate they will face multibillion-dollar budget shortfalls. New York’s budget office, for example, anticipates state revenue losses could be as high as $15 billion. The massive stimulus package also includes:
  • $200 million to be invested in telemedicine
  • $30 Billion for education funding
  • $25 Billion for public transit
  • $17 Billion for small businesses
  • $10.5 billion for the Pentagon, including $1.5 billion to deploy the National Guard
  • $10 billion Treasury loan for the Postal Service

SMB Relief

The 800-page Act includes many provisions to help small and medium-sized businesses (SMBs). It will provide $350 billion worth of loans to SMBs. Note: 
  • Small business interruption loans

    This is in addition to the Small Business Administration (SBA) Economic Injury Disaster Loan program, which provides loans up to $2 million and is available to SMBs in all 50 states. 

    Small businesses, non-profit organizations, sole proprietorships, and self-employed individuals with 500 or fewer employees per location are eligible for loans up to $10 million. The maximum interest rate is 4%.

    The loan can be used to provide:

    • Payroll
    • Mortgage or rent payments
    • Utility payments
    • Healthcare premiums
    • Other debt obligations

    Any portion of the loan used for payroll and existing debt obligations will be eligible for loan forgiveness for an 8-week period from the beginning of the loan, given they can maintain the equivalent number of full-time employees through June.

    Organizations that have already laid off workers due to the pandemic will still be eligible for the loans and loan forgiveness if they rehire their staff members.

    Portions of the loan used for payroll issued to workers who earn over $100,000 will not be forgiven.

    The stimulus legislation states portions of the loans used for covered expenses will convert to grants, but interest will still have to be paid.

    Loan forgiveness is reduced proportionately to any reduction in workforce or wages compared to the prior year.

    Businesses that receive funding under the “Paycheck Protection Program” are not eligible for the SBA EIDL loans.

  • Any portion of the loan used for payroll and existing debt obligations will be eligible for loan forgiveness for an 8-week period.

  • The Act also provides a refundable payroll tax credit equal to 50% of “qualified wages.

  • Qualified individuals will receive up to $1,200 per person (or $2,400 for married filing jointly) with an additional $500 per child. The benefit decreases by $5 for every $100 in income over $75,000 and will not be paid to single taxpayers who make $99,000 (or $198,000 for married filing jointly).

  • Federal Income Tax Returns normally due on April 15 will not be due until July 15, 2020.

  • The Act extends unemployment benefits from 26 weeks to 39 weeks. The benefit amount is calculated under state law, plus $600 in federal funding per week up to 4 months. It will also waive the one-week waiting period.

  • It also provides unemployment benefits for self-employed workers and contractors.

The legislation is surprisingly vague on exactly how the money will be distributed, although most of those who have been working to shape it assume that HHS Secretary Alex Azar will likely have a major role to play.

The information provided on this website is intended for informational purposes only.  As more details emerge, we will continue to update this article. Millennium Medical Solutions Corp. does not offer legal or medical guidance.  Those with legal or medical questions should seek appropriate assistance from a licensed professional.  Stay up to date by signing up for Newsletter and Coronavirus Dashboard below.

Learn how our PEO Partnership can help your group please contact us at info@360peo.com or (855)667-4621.

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NY “Emergency COVID-19 Paid Sick Leave”

NY “Emergency COVID-19 Paid Sick Leave”

NY “Emergency COVID-19 Paid Sick Leave”

From our preferred DBL Partners, ShelterPoint

Until the Federal program (“Families First Coronavirus Response Act”) becomes effective in April to help ease some of the financial strains from the COVID-19 outbreak (the illness caused by the novel Coronavirus), NY State is helping fill the void on the State level through “Emergency COVID-19 Paid Sick Leave” for employees who can’t work while under quarantine. This means, starting April 1st, the Federal program becomes the primary source of COVID-19 paid sick leave.

​How is COVID-19 quarantine defined under the NY law? Under what circumstances does a quarantine qualify for benefits under this act?

“Emergency COVID-19 Paid Sick Leave” applies to employees who are ordered by the State of NY, Department of Health, a local Board of Health, or any other governmental entity to be under mandatory or precautionary quarantine/isolation due to COVID-19.

  • The “Order for Quarantine” is official written documentation issued to individuals who need to be isolated. See a sample here.
  • The quarantine/isolation under this act does NOT apply to New York State on Pause or general stay-at-home orders.
  • The Centers for Disease Control and Prevention (CDC)* define isolation and quarantine as follows:
  • Isolation separates sick people with a quarantinable communicable disease from people who are not sick.
  • Quarantine separates and restricts the movement of people who were exposed to a contagious disease to see if they become sick.

Further, in order to qualify, the employee must be unable to perform their core job duties or any alternative responsibilities the employer may offer during the quarantine.

If the employee doesn’t show any symptoms (or has not been diagnosed yet) and can work while under quarantine, “Emergency COVID-19 Paid Sick Leave” benefits do not apply.

Does the NY law apply to employees not working due to “New York State on Pause” or stay-at-home orders in NY State?

No, the “Emergency COVID-19 Paid Sick Leave” or “New York State on Pause” does not apply if an employee has to stay home or work remotely for circumstances other than a mandatory quarantine described above. This means, the following situations, for example, do not apply:

  • Watching kids during school closure
  • Working from home
  • Voluntarily self-quarantining “just in case”
  • Being home because the business is temporarily closed

How does the COVID-19 Paid Sick Leave work?

Eligible employees receive job protection (in form of job restoration and non-retaliation provisions) and paid sick leave during the time of their qualified quarantine. The actual benefit structure depends on the size and annual net income of the employer:

Employer Size (by employee count) Job protection

 

Covered Duration

Starting 3/18/20

Employer’s Role

 

Employee’s pay/benefits

Starting 3/18/20

1-10

(less than $1m annual net income)

Yes Duration of quarantine until Federal program starts (unless NY has richer benefits) Unpaid sick leave until end of quarantine

Sick leave is entirely compensated through DBL/PFL benefits concurrently:

Combined maximum of $2,884.62/week

1-10

(more than $1m annual net income)

Yes Duration of quarantine until Federal program starts (unless NY has richer benefits)

At least 5 days paid sick leave by ER

+

Unpaid sick leave until end of quarantine

Days 1-5:

Full salary continuation by employer

 

Days 6+

Concurrent DBL/PFL benefits:

Combined maximum of $2,884.62/week

11-99 Yes Duration of quarantine until Federal program starts (unless NY has richer benefits)

At least 5 days paid sick leave by ER

+

Unpaid sick leave until end of quarantine

Days 1-5:

Full salary continuation by employer

 

Days 6+

Concurrent DBL/PFL benefits:

Combined maximum of $2,884.62/week

100+ Yes At least 14 days Full duration paid at regular salary by ER Full salary continuation by employer
Public Employers Yes At least 14 days Full duration paid at regular salary by ER Full salary continuation by employer

 

How long does the COVID-19 Sick Leave last?

The intended duration is the period of quarantine only, i.e. 14 days. However, there are a few things to note:

  • “Emergency COVID-19 Paid Sick Leave” became effective on March 18th and does not retroactively apply to quarantines before that date.
  • If an eligible quarantine started prior to that date and stretches past March 18th, only the days from March 18th onward qualify.
  • Once the Federal program goes into effect, benefits under the NY program will be replaced by the Federal program (unless NY has richer benefits, see below for details), even if the 14-day quarantine is not completed yet. This means, employees will have to file a new, federal claim for the remainder of their quarantine. Visit this post for details on the Federal “Families First Coronavirus Response Act”.

Is the COVID-19 sick leave coming from the employee’s own bucket of accrued sick leave days?

No, the Sick Leave provided under this act is not taken from an employee’s accruals.

Is the COVID-19 benefit duration under DBL/PFL reducing the total available benefit time available under those coverages?

Yes, DBL/PFL time taken under COVID-19 benefits counts as duration taken under State disability (maximum of 26 weeks per year) and Paid Family Leave (maximum of 10 weeks in 2020) and  reduces the remaining benefit durations accordingly.

How much is the DBL/PFL benefit?

The combined maximum of $2,884.62/week consists of a Paid Family Leave portion and a short-term disability portion. Both benefits run concurrently, meaning one part of your COVID-19 sick pay is paid through PFL and the rest through DBL at the same time:

  • The first 60% of the weekly salary are paid through the Paid Family Leave benefit bucket, to a maximum of $840.70/week.
  • The amount of the DBL benefit depends on the employee’s weekly salary – it’s the difference between the salary less the PFL portion of the benefit. The DBL portion is capped at $2,043.92/week.

Here are 3 examples:

  Weekly salary

 

PFL benefit portion

(60% of weekly salary, capped at $840.70)

 

Weekly salary minus PFL amount

(capped at $2,043.92)

Total Benefit amount/week
Jane $1,000.00 $600.00 $400.00 $1,000.00
Jamal $2,000.00 $840.70 $1,159.30 $2,000.00
Anne $3,000.00 $840.70 $2,043.92 $2,884.62

 

 

When does the DBL/PFL benefit start?

For purposes of the “Emergency COVID-19 Paid Sick Leave”, the 7-day waiting period under DBL is waived. Benefits start on the employee’s first full day of unpaid quarantine starting March 18th. Here’s what that means:

  • If an eligible quarantine started prior to that date and stretches past March 18th, only the days from March 18th onward qualify.
  • Employees at a small business with less than 10 employees – and that has less than $1m in annual net income – are eligible to get their income replacement back to day 1 of the quarantine through their DBL/PFL insurance.
  • However, if a small business with 1-10 employee has more than $1m in annual net income, the employer has to pay the first 5 days before DBL/PFL benefits become payable to cover the remaining quarantine time from day 6 on.
  • The same applies to businesses that have between 11 and 99 employees.
  • Employees at organizations with 100+ employees and employees of public employers do not get their paid sick leave through DBL/PFL benefits under this act – their employer must continue their full salary for the duration of the quarantine.

Does Emergency COVID-19 Paid Sick Leave apply to the Quarantine/Isolation of an Employee’s Child?

Yes. The legislation provides Paid Family Leave for working parents if their minor dependent child has to go into mandatory or precautionary quarantine/isolation. In addition to job protection, eligible employees may receive a maximum benefit of $840.70 per week for the duration of the quarantine.

When does the Emergency COVID-19 Paid Sick Leave take effect?

The provisions of the quarantine legislation take effect immediately upon the date of Governor Cuomo’s signature (March 18, 2020) ensuring that New York workers will be able to take advantage of these benefits starting March 18th.  However, the “Emergency COVID-19 Paid Sick Leave” does not retroactively apply to quarantines before that date. So, if an eligible quarantine started prior to that date and stretches past March 18th, only the days from March 18th onward qualify.

How does NY’s Emergency COVID-19 Paid Sick Leave relate to the Federal “Families First Coronavirus Response Act”?

Once the Federal Program goes into effect in April, it will become the primary source for COVID-19 benefits. In other words, most New Yorkers looking to request benefits after that date, need to file for support on the Federal, not the State, level.

After that date, the NY program will only be available for New Yorkers who exceed the Federal program’s salary cap and can file for supplemental benefits bridging between the Federal and State caps.

  • NY program apply to quarantines that started before the Governor signed enacted the “Emergency COVID-19 Paid Sick Leave”

 

Learn how our PEO Partnership can help your group please contact us at info@360peo.com or (855)667-4621.

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How Does My Insurance Cover Coronavirus

How Does My Insurance Cover Coronavirus

 **  April 18, 2023- Covid-19 Public Health Emergency Ending May 11, 2023  **

As a business organizational Coronavirus Preparedness Plan is necessary step but how about your sponsored group healthcare plan?  Does your your Insurance cover Coronavirus testing and treatment?

There has been a lot of news coverage recently about the Coronavirus: Type COVID-19 outbreak. You and your family may have questions about the outbreak and want to know how to stay healthy. For the latest information, please visit the New York State Department of Health, NJ, CT and the Centers for Disease Control and Prevention websites. You will find updates on this rapidly changing situation, plus prevention advice and instructions.

 In most traditional group health plan arrangements, testing for COVID-19 should be covered  like other diagnostic tests (e.g., the flu test or rapid strep test) when medically necessary. States like NY, CA, OR and Washington have issued requiring (among other things) insurance carriers to cover services associated with testing for the COVID-19 without cost-sharing. It is likely that other States will adapt similair rules shortly. 

In light of the spread of COVID-19 and their goal of supporting the health and well-being of their members, the following resources are now available for members in all markets and all group sizes.

 

ShelterPoint DBL

March 25, 2020-   NY “Emergency COVID-19 Paid Sick Leave” ​How is COVID-19 quarantine defined under the NY law? Under what circumstances does a quarantine qualify for benefits under this act?“Emergency COVID-19 Paid Sick Leave” applies to employees who are ordered by the State of NY, Department of Health, a local Board of Health, or any other governmental entity to be under mandatory or precautionary quarantine/isolation due to COVID-19. More

New York vs. New Jersey: How Does Their Statutory Disability Insurance Coverages Compare?

NYS Emergency COVID-19 Paid Sick Leave infograph

 

 

 

 

 

 

 

Overview NY Emergency COVID-19 Paid Sick Leave

Aetna

1. For the next 90 days, Aetna will offer zero co-pay telemedicine visits for any reason.

  • Aetna is recommending members use telemedicine as their first line of defense in order to limit potential exposure in physician offices.
  • Cost sharing will be waived for all video visits through the CVS MinuteClinic app, Aetna-covered Teladoc offerings and in-network providers delivering synchronous virtual care (live video-conferencing).

Click on the links below for Teledoc Coronavirus Flyers.

2. Aetna will waive co-pays for all diagnostic testing related to COVID-19.

  • This policy will cover the test kit for patients who meet CDC guidelines for testing, which can be done in any approved laboratory location.
  • Aetna will waive the member costs associated with diagnostic testing at any authorized location.
Amerihealth

Testing will be covered. During this public health crisis, AmeriHealth New Jersey will cover as a preventive service and waive cost sharing (such as co pays and coinsurance) for the COVID 19 test when performed at a hospital or an approved laboratory.

Telemedicine is available. To help reduce potential exposure, AmeriHealth New Jersey also encourages members to utilize telemedicine services if they are available as part of a member’s plan. To encourage use of these services, AmeriHealth New Jersey will waive member co pays where applicable for telemedicine visits for the next 90 days. To access telemedicine options, members should login to our member website at amerihealthnj.com.

Treatment will be covered. At this time, there is no specific antiviral treatment or vaccine for COVID 19. Members should receive care from their doctor to help relieve symptoms as they would other viral respiratory infections. AmeriHealth New Jersey continues to cover medically necessary health care costs to treat infectious diseases, including COVID 19, based on the terms of the member’s insurance plan.

Prescriptions can be filled. AmeriHealth New Jersey has lifted prescription refill restrictions on maintenance medications, such as the “refill too soon” limit, for members in states that have declared a state of emergency because of the virus. We are carefully monitoring COVID 19 developments and will make adjustments to policies as appropriate. We recommend that members call the Pharmacy Services number on their ID cards as needed if they require additional medication refills due to a potential quarantine situation.

EmblemHealth
EmblemHealth has confirmed that telemedicine is available in all Small Group plans, including the HSA plans.    GHI and HIP
Cost sharing for telemedicine has been waived for HSA plans.

• Telemedicine: TELADOC EmblemHealth To reduce urgent care and emergency room visits during the outbreak as well as provide peace of mind, members can access their available telemedicine benefit by going to teladoc.com or call 800-TELA-DOC (800-835-2362).

• 24/7 Nurse Line: As always, EmblemHealth’s 24-Hour Nurse Line, is available and members can speak with an experienced, licensed nurse anytime. Members can call 877-444-7988 for confidential, one- on-one health counseling and accurate information to help make informed health care decisions.

• Benefits and cost-sharing: Cost-sharing as required by the state for testing, as well in-network cost-sharing for physician’s office visits, urgent care visits and emergency room visits associated with testing are being waived. EmblemHealth will not require preauthorization for COVID-19 testing.

• Provider assistance and tools: Ensuring affordability and keeping costs down is all our responsibility including our providers. We are working closely to ensure our providers have the latest information and tools to help in diagnostic practices and testing protocols.

• AdvantageCare Physicians access: ACPNY is prepared to receive people in need of care. Isolation rooms, screening protocols, and direct contact with testing centers, are in place to ensure proper care and the protection of our employees and patients. People should call their primary care physician before seeking care at a physical location.

Resource: https://www.emblemhealth.com/live-well/covid19

Empire and Anthem Blue Cross

Amid the growing concerns about the spread of COVID-19 in communities across the country, Anthem is eliminating the burden of additional costs for members in its affiliated health plans by providing coverage of the coronavirus screening test at no out-of-pocket cost.

Will my Empire benefits cover COVID-19 testing and care?

Don’t worry — if your in-network provider orders a coronavirus test, your Empire health plan will cover the cost for the test and the in-network provider care visit and you will not be subject to any cost sharing.

Empire is waiving these costs for all affiliated fully-insured, Individual, Medicaid and Medicare plans. For high deductible health plans your deductible will apply. For self-funded plans, check with your employer or call the number on your ID card.
Please encourage your employees to visit anthem.com/blog, anthem.com/ca/blog, or empireblue.com/blog where they can always find the most up-to-date information.
The updated flier will soon be available in Spanish and other required languages (including Chinese, Vietnamese, Korean, Tagalog, and Cantonese).
View our press release here.
Healthfirst

HealthFirst COVID-19 Resource Page – Healthfirst is actively monitoring the Coronavirus (COVID-19) outbreak and is here to help you get access to the care you need. Continue to check this page as it will be updated as new information becomes available.  

Will my Healthfirst benefits cover Coronavirus (COVID-19) testing and evaluation?
Healthfirst is waiving co-pays for all diagnostic testing and evaluations related to coronavirus. This means that if your PCP or in-network provider orders a coronavirus test, your Healthfirst health plan will cover the cost for the test and the in-network provider visit related to the coronavirus evaluation. You will not be subject to any cost sharing for the test or the in-network provider visit.

Finding Care

Call your doctor if you develop a fever, have a cough, or have difficulty breathing. Let your doctor know if you’ve been in close contact with a person known to have Coronavirus (COVID-19), or if you live in or have recently traveled to an area where the coronavirus virus has spread. Be sure to carefully follow your doctors’ instructions.

You can also receive virtual care. The Healthfirst Teladoc (telehealth) service is available for eligible members* and is covered for coronavirus related services. If you think you may be infected, Teladoc doctors can answer questions about the disease, evaluate your risk, and advise you on next steps. The Teladoc clinical team is trained on the latest protocols for local and national notification, testing, and management of people under investigation for the coronavirus.

Request a Teladoc visit by phone at 1-800-Teladoc (1-800-835-2362) or by visiting this website.

Horizon

Horizon Blue Cross Blue Shield  NJ HBCBSNJNew Jersey’s largest health insurance provider, Horizon Blue Cross Blue Shield of New Jersey, will cover all COVID-19 tests, the company announced in a press release.

Horizon said there would be a number of other coverage changes for their over 3.2 million members in relation to COVID-19, also known as coronavirus or the novel coronavirus. They include:

Effective Immediately, Horizon BCBSNJ is taking these steps:

    • Waiving prior authorizations for a visit to a primary care physician, urgent care center, or emergency room for evaluation of upper respiratory symptoms, fever, shortness of breath or other conditions that may represent COVID-19.
    • Waiving prior authorizations for diagnostic tests and for covered services that are medically necessary and consistent with CDC guidance if diagnosed with COVID-19.
    • Waiving prior authorization for lab studies or diagnostic testing required during an ER evaluation or inpatient hospital stay.
    • Waiver of Prior Authorization for diagnosis of COVID-19
      • We will cover, with no cost share to the member, the appropriate medically necessary diagnostic testing for COVID-19.
      • Horizon will cover the full cost of the COVID-19 test
        • Waive early medication refill limits on 30-day prescription maintenance medications (consistent with member’s benefit plan) and/or encourage members to use 90-day mail order benefit. Horizon will also ensure formulary flexibility if there are shortages or access issues and not hold patients liable for additional charges stemming from obtaining a non-preferred medication resulting from shortages or access issues.
        • Increased access to prescription medications  Access to Telehealth and Nurse Advice Hotlines 
          • 24/7 access to free telehealth services staffed by nurses trained to help patients who believe they are experiencing COVID-19 symptoms. Members can also use these services for other ailments in order to avoid trips to the doctors office or urgent care facilities.  Those service are available through the company’s free “Horizon Blue” app, the www.HorizonBlue.com online portal, or by phone at 1-888-624-3096. Members may also use those services to consult with a nurse about other health concerns and potentially avoid a visit to a physician office or urgent care facility.  
          • Relaxation applies to covered services delivered by video or telephone from in-network and out-of-network health professionals.
          • Waiving member cost-sharing for covered services provided by an in-network health care professional for telemedicine visit.
          • Applies to all covered IN-NETWORK  ONLY services delivered by telemedicine including those provided by primary care doctors, specialists, therapists, mental health and substance use treatment professionals, or urgent care doctors.
        • April 20, 2020 –  Horizon COVID-19 Resource Guide
        • Apri 6, 2020 – Horizon COVID-19 Resource Guide
        • March 31, 2020 Horizon Update: effective 4/1 credit card payments will be accepted by phone. No fees. Call 1-800-225-1955 

        • March 31, 2020 Horizon Update- Waiving Rules to Speed Hospital Admissions

        • Helping Impacted Employees Maintain Health Coverage

        • Horizon COVID-19 FAQ

MVP

All fees associated with COVID-19 testing are waived for MVP members in Commercial fully insured plans, Medicare plans, Medicaid Managed Care, and Child Health Plus. The directive issued by DFS does not apply to self-funded plans, but MVP’s self-funded employer groups have the option to implement the waived cost-share. The same rules for New York will apply to Vermont Commercial members of MVP.

MVP will continue to monitor the COVID-19 situation and share the most up-to-date information at mvphealthcare.com/COVID19.

MVP – MyVisitNow and MyERNow MetroPlus (No telemedicine app-need to call Physician direct)

For additional resources about COVID-19, please go to:

MVP Health Care
Oscar

New 2019 OscarIn response to the growing number of cases related to COVID-19 (colloquially known as the coronavirus), we want to let you know that Oscar is here to help keep your employees safe and informed as the situation progresses.

To support the health and safety of your clients, we are making the following resources available to Oscar members:

  • Waiving cost-sharing for COVID-19 diagnostic testing. If your client’s doctor recommends they should be tested for COVID-19, they will not be charged for the lab test.
  • Continuing to offer $0 telemedicine services (Doctor on Call).* Telemedicine is a great option for people who think they could have COVID-19. Our telemedicine PCPs can recommend COVID-19 testing and direct your clients to the right place for testing.
  • An online COVID-19 resource center: hioscar.com/covid19. We created this webpage so Oscar members can stay up-to-date on the latest information and understand their care options.
  • Oscar | How to help your clients worried about premium payments
As a reminder, Oscar members have access to our Doctor on Call service 24/7 and our Concierge team is prepared to support in any way. Your clients can call their Concierge team at 1-855-672-2755. They can also secure message Concierge or request a Doctor on Call consultation from their Oscar app or online account (hioscar.com/member) at any time.
Oxford

Oxford UHCAs a commitment to our members and their communities, UnitedHealth Group has done the following:

Learn more from UnitedHealth Group’s full announcement.

For additional resources including an uhc-member-faq-coronavirus-2020 available to members, please see Important Information for Members from UnitedHealthcare on COVID-19. We will continue to provide updates as we monitor the situation.

What we know about the virus

Coronaviruses are an extremely common cause of colds and other upper respiratory infections. The symptoms can include a cough, possibly with a fever and shortness of breath. There are some early reports of non-respiratory symptoms, such as nausea, vomiting, or diarrhea. Many people recover within a few days. However, some people — especially the very young, elderly, or people who have a weakened immune system — may develop a more serious infection, such as bronchitis or pneumonia.

Should you worry about catching this virus?

Unless you’ve been in close contact with someone who has the coronavirus — right now, this typically means a traveler from Wuhan, China who actually has the virus — you’re likely to be safe. In the US, for example, all five cases of the virus were recent travelers to Wuhan. The CDC maintains the risk is low to Americans, however, “we need to be preparing as if this is a pandemic, but I continue to hope that it is not,” said Dr. Nancy Messonnier, director of the CDC’s National Center for Immunization and Respiratory Diseases.

How can I protect myself? 

Much like prevention of the spread of any other infectious disease, basic hygiene principles are key to curbing the spread of this virus.

  • Wash your hands often with soap and water for at least 20 seconds. Use an alcohol-based hand sanitizer that contains at least 60 percent alcohol if soap and water are not available.
  • Avoid touching your eyes, nose and mouth with unwashed hands.
  • Avoid close contact with people who are sick.
  • Stay home when you are sick.
  • Cover your cough or sneeze with a tissue, then throw the tissue in the trash.
  • Clean and disinfect frequently touched objects and surfaces.

    Resource:

    Please contact us for further information or if you need assistance creating a workable plan. The information provided on this website is intended for informational purposes only.  Millennium Medical Solutions Corp. does not offer legal or medical guidance.  Those with legal or medical questions should seek appropriate assistance from a licensed professional.

    Avoid Premium Payment Delays ACH

    As the COVID-19 situation continues to evolve, we would like to remind brokers that ACH/EFT payments are a great way to avoid processing delays With many carriers now working remotely, it’s likely that live checks will be subject to delayed processing. 

    For information about transparency providers and new tech tools contact us at info@medicalsolutionscorp.com or (855)667-4621.

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