Shelton, CT 06484
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Amwins Connect has gathered responses from each of our carrier partners regarding the COVID-19 (Coronavirus) outbreak.
Click on the carrier names below for key highlights. Contact us with any questions and we will work diligently to provide answers.
Click here to review the U.S. Chamber of Commerce's Coronavirus Emergency Loans Small Business Guide and Checklist.
To view the most recent update from each carrier please click on their name below.
This page will be continuously updated as we receive more detail and points of clarification from our carrier partners.
As of January 15, 2022, health plans are required to cover the cost of 8 FDA approved over-the-counter (OTC) in-home diagnostic tests, per member per month. The guidance is applicable to self-insured and fully insured group health care plans, including grandfathered health plans (“plans”):
CARRIER | CLAIM SUBMISSION PROCESS | RETAIL PURCHASE WITHOUT CLAIM SUBMISSION | RESOURCES |
---|---|---|---|
Anthem (CT & NH) |
Members can submit for reimbursement through Anthem's member portal (select Claims & Payment after logging in). Members can also order tests online using the Sydney Health mobile app. |
Not available at this time. | OTC Testing Coverage |
Cigna + Oscar (CT) | A claims reimbursement process will be available soon. | C+O recommends members show their ID card to the pharmacy and request they will your insurance. They understand this may not be accepted as many pharmacies are still working through how to set up this process. | OTC Home Test Reimbursement |
Emblem Health | Members can submit for reimbursement through Emblem Health's online prescription reimbursement site. | Not available at this time. | |
Empire BlueCross BlueShield | Members can submit for reimbursement through Empire's member portal (select Claims & Payment after logging in). Members can also order tests online using the Sydney Health mobile app. |
Not available at this time. | OTC Testing Coverage |
Harvard Pilgrim Health Care | A claims reimbursement process will be available soon. | Not available at this time. | COVID Guide to Care |
Healthfirst | A claims reimbursement process will be available soon. | Not available at this time. | OTC Testing Coverage |
UnitedHealthcare & Oxford | Members can submit for reimbursement through UHC's member portal. | Members who have pharmacy benefits administered by OptumRx will have no up-front cost when purchasing through Walmart Pharmacy or Rite Aid Pharmacy (members can determine they are through OptumRx by the logo on their ID card. UHC is working to add additional retailers. |
Individuals can request free rapid antigen home tests, without shipping fees, from the federal government.
Q: Can Plan Participants make mid-year election changes to their dependent care assistance FSA plan?
A: Yes, they may make any of the following changes to their election choices if your plan agrees to allow them. These changes would be effective through December 31, 2020 and if made, would be effective on a prospective basis only.
Q: Can Plan Participants use any unused amounts in their Dependent Care Assistance FSA plan?
A: Yes, if the plan wants to allow this change, unused amounts remaining in the Dependent Care Assistance FSA plan as of the end of the grace period or plan year ending in 2020, the plan may permit plan participants to apply those unused amounts to pay or reimburse dependent care expenses incurred through December 31, 2020.
Q: Can Plan Participants make mid-year election changes to their Medical FSA plan?
A: Yes, a Plan Participant may make any of the following changes to their election choices if your plan agrees to allow them. These changes would be effective through December 31, 2020 and if made would be effective on a prospective basis only.
Q: Can Plan Participants use any unused amounts in their Medical FSA plan?
A: Yes, if the plan wants to allow this change, unused amounts remaining in the Medical FSA plan as of the end of the grace period or plan year ending in 2020, the plan may permit plan participants to apply those unused amounts to pay or reimburse eligible medical expenses incurred through December 31, 2020.
Q: Can our Plan Participants carryover more than a maximum of $500 at the end of our Medical FSA plan year?
A: IRS Notice 2020-33 allows Employers/Plans to increase the maximum "carryover" amount for the Medical FSA to be up to 20% of the Annual Maximum Medical FSA contribution amount which is currently $2,750.00. Therefore the 20% of $2,750 would allow up to $550.00 as your new "carryover" maximum. However, if your Medical FSA plan's annual contribution amount is less than $2,750.00, the carryover amount cannot be more than 20% of the plan's stated maximum contribution amount (i.e. if your annual Medical FSA contribution maximum is $2,000.00, then 20% of that amount would represent a $400.00 "carryover" maximum).
Q: Has there been clarification on allowing a qualified high deductible health plan (QHDHP) to cover telemedicine services before?
A: Yes, in IRS Notice 2020-29, there is clarification and a revision to the CARES Act allowing a QHDHP to cover telemedicine before the deductible has been met to be effective retroactively to January 1, 2020. This is allowed through the end of the plan year beginning on or before December 31, 2021.
Q: Are there any special considerations for employers that offer Medical FSAs and Health Savings Accounts (HSAs)?
A: Yes, Employers who offer Medical FSAs and Health Savings Accounts (HSAs) will need to determine whether the extension period is beneficial for HSA-eligible participants. An HSA-eligible participant who is permitted to continue to access unused Medical FSA funds will be disqualified from making or receiving pre-tax HSA contributions during the extension period.
The Department of Labor and the Department of Treasury are extending certain timeframes applicable to group health plans, disability and other welfare plans under ERISA and the Code.
Q: Which employer plans are specifically affected by the Extension Timeframes?
A: Group health plans, disability and other employee welfare benefit plans, and employee pension benefit plans subject to ERISA or the Code must disregard the period from March 1, 2020 until 60 days after the announced end of the National Emergency or such other date announced by the Agencies in a future notice (the "Outbreak Period") in determining the following periods and dates.
Q: What is the effective date of the Extension Timeframes?
A: Effective March 1, 2020 individuals have relief for the following scenarios. Individuals have until 60 days after the announced end of the National Emergency or a date specifically announced by the Federal Agencies in a future notice.
Q: What are the different scenarios effected by the Extension Timeframe change?
A: The different scenarios are listed below with examples.
The 30-day period to request special enrollment under ERISA and the Code.
The 60-day election period for COBRA continuation coverage under ERISA and the Code.
For example: an employee loses coverage March 31, 2020. Under the COBRA rules (prior to the National Emergency) the individual would have until May 30, 2020 (60 days) to elect COBRA coverage. Under the COVID-19 National Emergency, also called the Outbreak Period, if we receive guidance that the Outbreak Period ends July 31, 2020, the individual would have another 60 days, or until September 29, 2020 to elect COBRA coverage.
COBRA premium payments can no longer be required during this National Emergency. So as an example, an individual elects to go on COBRA effective March 1, 2020 and guidance was issued ending the National Emergency/Outbreak Period on July 31, 2020, the individual has until August 30, 2020 (30 days after July 31, 2020) to pay premiums for March, April, May, June and July. The individual remains eligible for benefits during this entire timeframe and is not to be denied coverage.
In addition: With respect to group health plans Sponsors and Administrators, the Outbreak Period shall be disregarded when determining the date for providing a COBRA election notice.
All claims that fall under ERISA guidelines would be included in this specific extension. This would include Medical, Dental, Vision, Medical or Dependent Care FSA, Health Reimbursement Arrangements (HRAs) and Health Savings Accounts (HSAs).
As an example, an individual is enrolled in the Group Health Plan and a Medical FSA account. The Medical FSA plan requires all claims to be submitted within 90 days after the end of the Plan Year for expenses incurred prior to the end of the Plan Year.