FREQUENTLY ASKED QUESTION answered by Employee Benefits Corporation
What Benefit Changes Can I Make Due to COVID-19?
Many employers are having to make difficult decisions regarding staffing during the national pandemic due to COVID-19. Employers are faced with staff leave of absence situations including layoffs, furloughs, and reduction in hours. This leads to questions regarding what changes employees are able to make to their benefits as a result. Answers to some of the more frequently asked questions are below:
Can I change my cafeteria Plan elections because of COVID-19 or financial hardships?
At this time, there has been no relief or relaxation of the Section 125 permitted election change rules. The Section 125 permitted election change rules do not permit changes based upon financial hardship.
Can I change my insurance plan (medical, dental, vision, etc) coverage elections as a result of COVID-19?
No. The pandemic itself is not an allowed permitted election change event. However, if coverage is significantly improved based on changes to the plan the carrier makes midyear, this could qualify as a permitted election change event.
Can I change my Health FSA as a result of COVID-19?
No. The pandemic itself is not an allowed permitted election change event. In addition, if a participant or a dependent tests positive to COVID-19, they cannot change their Health Care FSA election for that reason alone.
Can I change my Dependent Care FSA as a result of COVID-19?
While the pandemic itself is not a reason to make a change, there is a lot more flexibility with these plans which would result in a permitted election change. Changes in providers and changes in costs for daycare ARE permitted election change events that allow participants to make corresponding prospective changes to their Dependent Care FSA elections as long as the request is made timely.
I have a qualifying election change event, how long do I have to change my election?
Keep in mind that any permitted election changes must be made timely, which for most plans is 30 days from the qualifying event. Please refer to the employer plan documents and summary plan description (SPD) for specific timelines.
In keeping with our promise to continually update you regarding COVID-19, please see answers to FAQs below from Anthem.
Coronavirus COVID-19 frequently asked questions
What it is, how to prevent it, what Anthem benefits cover.
Colonial Life is continuing to make adjustments to its life plans as we continue through the COVID pandemic. They are now waiving paramed and lab work (specific amounts and ages) to help with social distancing so that people get life coverages they want and need. Please reach out with any questions you may have or if you have a group that would like to implement this for a 5/1 coverage effective date. Colonial Life is a leader in technology with enrollments. We can open a new account(digital), benefits counsel (webinar/digital packets) and enroll employees(cobrowse/telephonic). We can help your clients all while social distancing.
Enhanced Underwriting guidelines for Life products (Updated: 03/26/2020)
To support COVID-19 social distancing awareness, Colonial Life has implemented enhanced “non-med” Underwriting requirements on life insurance through June 30, 2020. The purpose of these enhanced requirements is to alleviate the concerns of applicants who would otherwise need to meet with a paramedical examiner for labs and an exam. The guidelines for face amounts by age are listed below:
“Non-Med” (No Labs or Paramedical Exam) Life Guidelines
Age Band Face Amount Enhanced UW Guideline
Age 17-50 $250,000 or less Exams not required
Age 51-60 $150,000 or less Exams not required
Age 61+ Normal process in place
The COVID-19 pandemic is a rapidly evolving situation. Policies and information are changing quickly as we work together to address the health and safety of our members and communities. We will continue to do our best to provide timely updates as the situation evolves.
For more information on COVID-19, visit our website where we have information dedicated to this pandemic. Please feel free to share these resources with your clients.
Delta Dental of Wisconsin
Frequently Asked Questions about Benefit Coverage During COVID-19
Dental and Vision Plans
If an employer has to terminate all employees and then rehire them, would the group contract remain active?
Yes. The group contract would remain active with no members and then will resume coverage when employees are rehired. We will waive eligibility waiting periods for employees returning to work after layoff or furlough. Rates and plan benefits would not change until the contract renewal. Members will not have coverage for services during this time.
Will coverage terminate if the payment is late?
No. Delta Dental of Wisconsin is extending our premium grace period from 31 to 60 days. Clients with delayed premium payments may still receive payment reminders but rest assured that we will continue to provide coverage and pay claims during this time.
Example: Premium due 3/01/20 has a standard grace period to 4/1/20 before cancellation. The grace period is now extended to 5/1/20. Claims received during the extended grace period will be processed.
If an employee’s hours are reduced to a level below the member definition, will they retain coverage?
Yes. We understand that businesses may need to adjust their workforce during this time. We are allowing flexibility in the plan eligibility definition and will consider them eligible for coverage as long as you do and premium payments are received.
How long will coverage continue for employees whose hours are reduced?
We realize that this is an unprecedented time and there is great uncertainty as to how long this situation will last. We understand businesses want to do what is best for their employees, so we will consider them eligible if you do.
Does Delta Dental of Wisconsin cover teledentistry claims?
Yes. We will adjudicate claims the same as we do today for services received in person or through teledentistry. The ADA has given guidance to providers on how to submit these claims. Members should contact their dental office to find out if their provider has the ability to offer services through teledentistry.
What if a member or dependent is actively receiving orthodontic treatment and the employee was temporarily laid off?
For orthodontia in progress, our normal terms will apply. Please refer to your plan documents for details.
If you have further questions about your dental or vision coverage with Delta Dental of Wisconsin, please contact us at Sales@deltadentalwi.com.
GHC (add or delete what you feel will be good information)
As you are aware, COVID-19 has limited access to routine dental care, with providers offering emergency-only services in most cases. As a result, we would like to offer some relief to our customers – your clients. To help do that, we are pleased to announce that will be offering a premium credit to fully-insured dental and vision groups and individual customers, and an administrative fee credit to self-funded dental and vision customers.
Credit details for group dental and vision, and individual dental members:
• We will offer a 50% credit to April 2020 billed premiums and self-funded administrative fees. This is a one-time credit, there will be no retroactivity refunds reflected on future invoices. For example, if a client adds a new subscriber in June with an effective date of April 1st, we will not credit the premium for that subscriber back to the group for the month of April.
• This credit will be applied to the June billing statement.
While we will be communicating the details of this program to our customers directly via email early next week, we encourage you to reach out to your clients as well to reinforce the details of this message.
We all play an important role in maintaining oral health for the customers and communities we serve. Here are a few additional examples of how we have provided support to assist all of our stakeholders:
• Recognizing the impact of temporarily closing dental practices has had on our network dentists, we implemented the Advance Payment Support Program that provides interest-free financial assistance to help them through this challenging time.
• To protect the health and well-being of our employees, more than 95% are working from home, and to help them adjust to their new normal, we are also offering alternate staffing programs to protect our workforce and ensure they are available when they are needed.
• To assist those who need support in the communities we serve, we have extended financial support to safety net clinics that treat the uninsured and underinsured population, and we’re providing food stability grants to programs across the state.
We are committed to helping our stakeholders during this challenging and ever-changing time. If you have any questions, please reach out to your Delta Dental Account Manager.
We would never have imagined that we would have a life experience like COVID-19. Yet, the simple truth is that our team is doing what it has always done — rising to the challenge time and time again, even in the face of adversity. We are #GHCSTRONG.
Updates from GHC-SCW on Coronavirus (COVID-19)
We do have some GHC-SCW updates to share. We encourage you to review these important changes below. Please continue to check our GHC-SCW website for the most up to date information. As always, we appreciate your kindness and patience during this time.
Click here to see our temporary clinic hours for each of our clinic locations.
GHC-SCW Capitol Clinic Pharmacy is closed to the public and only servicing the Urgent Care/Respiratory Clinic needs until further notice. We are directing potential COVID-19 patients only to that location. In an effort to curb community spread of COVID-19, GHC-SCW Sauk Trails and Hatchery Hill Pharmacies are offering FREE MAIL DELIVERY. In the event your prescription cannot be mailed, we also offer CURBSIDE DELIVERY.
Prescriptions that cannot be mailed are:
1. Refrigerated medications
2. DEA Schedule II medications (i.e., the prescription number on the bottle/package starts with “CII” and/or the package has “C2” on it). Examples of Schedule II medications include hydrocodone, Adderall, etc.
We strongly encourage you not to walk into our clinics or pharmacies unless you are there for an appointment. For mail or curbside delivery, please call Sauk Trails Pharmacy at 608-831-1773 or Hatchery Hill Pharmacy at 608-661-7220. For best service, call 1-2 business days in advance.
PHARMACY: CURBSIDE PICK UP PROCESS
· Use MyChart or call pharmacy to request refill.
· Before you drive to the clinic, please call in advance to set up payment.
· When you arrive at the clinic, stay in your car and call the pharmacy.
· A pharmacy staff member will bring your prescription to your car.
PHARMACY: MAIL DELIVERY PROCESS
· Call pharmacy and request refills be mailed to you.
· If your doctor orders you a prescription through mail delivery, you need to call pharmacy and confirm shipping details.
· Provide payment information at that time.
UNKNOWN CALLER/NO CALLER ID
GHC-SCW Providers may contact you via a “No Caller ID” line. Please pick up calls at or around your Telephone Visit appointment time even if “No Caller ID” is listed.”
STANDARD ACCESS CLINIC SYMPTOM SCREENING
Please know that we are taking great steps to serve and protect patients in our clinics. Patients with respiratory illness symptoms currently receive primary care and urgent care at our Capitol Clinic. Patients without respiratory illness symptoms are able to receive care at our Standard Access Clinic sites where we screen all members and employees who enter the buildings for COVID-19 symptoms. If you have an appointment, lab work or are picking up prescriptions at a Standard Care Clinic, please note that you, your children and any support people will be screened for respiratory illness and fever symptoms before entering. We apologize for any inconvenience this may cause.
We kindly request that members coming to our clinics please minimize the number of support people they bring with them. Ideally, the only patients who should bring a support person to the clinic are children, older adults and those with disabilities. This will help us to conserve supplies while also decreasing the spread of COVID-19.
NAVIGATING COMMUNITY RESOURCES
GHC-SCW has compiled a list of community resources that is updated daily to help members during this difficult time. This Resource Guide includes information on food access, financial support, transportation, health coverage and public assistance support, community agency updates and more. Please visit our COVID-19 web page for the most up-to-date information.
Below are several FAQs to help guide patients on how we all can be best prepared.
GHC-SCW COVID-19 Concerned Patient FAQ
GHC-SCW COVID-19 Exposed Patient FAQ
GHC-SCW COVID-19 Case Positive Patient FAQ
GHC-SCW COVID-19 Insurance Coverage FAQ
GHC-SCW Coping with COVID-19 Stress FAQ
GHC-SCW Social Distancing Resource Guide
GHC-SCW Community Resource Guide
GHC-SCW OBGYN Changes During COVID-19
We encourage our membership to utilize the following websites for information.
If you have any questions or need more information, contact your Guardian Group Sales Representative or visit guardianlife.com/coronavirus.
We know conducting business is challenging during the crisis and that you and your clients have questions. To help us better serve up timely content as it relates to your business, we’re trying a new format that will help us include more of what you need to know.
New COVID-19 advisor site
No matter your line of business, this site will be your go-to for all things COVID-19 impacting you and your clients—like underwriting, new business processes, digital marketing solutions, the Coronavirus Aid, Relief, and Security (CARES) Act, and more. Bookmark the new site for future reference. If you need to log in to the advisor site and forgot your password, call (800) 554-3395.
• The CARES Act and what it means for your clients. Get details for business owners and individuals. Coming by next week: New handy calculators to help your clients decide which financial relief options available through the Small Business Administration will work best for them. Check this page often for these and other tools to help businesses sift through the details of the CARES Act.
• Pandemic-related podcasts. Kara Hoogensen, Senior Vice President—Specialty Benefits, joins Jim Blasingame to talk about avoiding retirement panic with the stock market and how the government is helping small businesses. Listen to retirement podcast | Listen to small business podcast
• Rate stability for select renewals. To help during these challenging times, we’re simplifying renewal conversations for small business owners. Learn more
• Employee Assistance Program (EAP) support. Principal® and Magellan are extending telephonic EAP support to all group benefit customers during COVID-19. Contact Magellan Healthcare 24/7 at (800) 450-1327 for free, confidential consultation services.
Financial hardship and premium flexibility for life insurance policies in NY. On March 29, 2020, the Governor of New York issued Executive Order 202.13, which expires on April 28, 2020, unless subject to an extension. If a policyholder is unable to make a premium payment due to a demonstrated financial hardship, the insurer will allow premium to be paid over a 12-month period. This will include any notices of cancellation due to nonpayment in effect prior to the date of the Executive Order.
Here at Quartz, we took a moment to express our thanks to the essential workers keeping us healthy and safe during this pandemic.
Perhaps you, too, are an essential worker? Or, perhaps you have loved ones out there right now, family and friends on the front lines keeping our essential services available. No matter what, because we are all affected by this global crisis, we think it’s essential that you take care of YOU!
Because of COVID-19, some companies and employers are making the difficult decision to let go of employees. This means, of course, that individuals and families will lose employer-sponsored coverage.
Losing health insurance coverage is unfortunate at any time. But avoiding or minimizing a gap in coverage is especially important right now. Quartz has options available after loss of employer-sponsored coverage. These include individual and family plans, as well as Medicaid, and Medicare.
Here’s a summary you can share. It has key information, deadlines, and links to access information and apply for coverage. Options after loss of employer-sponsored coverage.
These are difficult times. Many companies are facing tough decisions. At Quartz, we’re doing everything we can to support our employer groups.
We hope it offers you some relief to know Quartz has updated its 90-day coverage extension for furloughed employees. Quartz will now allow continued coverage for employees on temporary leave or reduced hours until September 1, 2020.
You likely have questions. We’re here to answer them. You can access information on this and other issues and concerns about furloughs and layoffs: See Employer FAQ
As of September 1, 2020, the employee will need to either elect COBRA, state continuation coverage, or an ACA plan to remain covered. Employees in the probate period at the time of temporary leave or reduced hours will be allowed to come on to the plan per the group’s probate rules.
Please call Customer Service at (800) 362-3310 if we can help answer any other questions.
At Quartz, we’re doing all we can to keep you informed during this pandemic. We have several updates on the extension of timelines for enhanced benefits we already had in place.
Quartz has extended timelines for the COVID-19 viral test:
Quartz will continue to cover the following at 100% through July 31, 2020:
As a reminder, Quartz has updated its 90-day coverage extension for furloughed employees. We will now allow continued coverage for employees on temporary leave or reduced hours until September 1, 2020.
Learn more about enhanced member benefits and timelines: See COVID-19 updates
Check for additional updates: See Employer FAQ
Questions? Give us a call at (800) 362-3310. We’re here to support you
At TASC, we’re keeping employers and employees in mind as we monitor the ongoing congressional response to the COVID-19 pandemic. Two recently signed pieces of legislation contain important provisions, and an email will be sent to clients later today with instructions on what they need to do to maximize their benefit offerings.
The Coronavirus Aid, Relief, and Economic Security (CARES) Act allows tax advantaged plans like Healthcare FSAs and HRAs reimbursing 213(d) expenses to once again pay for or reimburse for over-the-counter (OTC) drugs and medicines. These items no longer require a prescription or physician’s note. In addition, expenses for menstrual care products will be treated as qualified medical expenses. This provision is effective for amounts paid and for reimbursement of expenses incurred after December 31, 2019.
Read more about the CARES Act, how the Special Interest Group for IIAS Standards (SIGIS) and merchants are preparing for this change, and the impact on participants: tascprovidernews.com/2020/04/01/the-cares-act-sigis-and-the-tasc-card
The Families First Coronavirus Response Act (FFCRA) included the Emergency Family and Medical Leave Expansion Act (EFMLEA), which amended the Family and Medical Leave Act (FMLA) to provide for emergency paid and unpaid leave for employee absences related to COVID-19. EFMLEA is applicable to employers with fewer than 500 employees even if the employer is not otherwise subject to FMLA.
Clients must update their Plan Document and Summary Plan Description (SPD) to incorporate the changes. See below for a breakdown:
1. Download and print the Plan Document Amendment & Summary of Material Modification (SMM).
• For HRAs reimbursing 213(d) expenses and all FSAs:
• For all other HRAs:
2. The company/plan sponsor representative will need to sign the SMM and file it with their Plan Document records. Clients do not need to send a signed copy back to TASC.
3. Clients will also need to distribute a copy of the SMM to all participating employees covered under the plan in the same manner they distributed their original Plan Document/SPD and any subsequent SMMs. This should be done as soon as possible.
We know that the COVID-19 pandemic has created a time of great uncertainty and complexity for our customers. As part of our commitment to supporting you, your clients and their employees, we would like to offer some clarity — about how we’re responding as the virus spreads, and about the evolving impacts of COVID-19 legislation.
We’re meeting a surge in claims by staffing up and streamlining
As we predicted and planned for, we are now seeing a surge in Short Term Disability claims and requests for leave coming through our Absence Management Center. To help reduce service disruptions, we’ve staffed up in critical front-line areas and established a dedicated team to process FMLA leaves now that the law covers leave for COVID-19-related reasons. We continue to streamline internal processes wherever possible so we can manage the increased volume while making decisions quickly and effectively.
Our people are more committed than ever to helping employees get the benefits they need. We ask for patience as they take an unprecedented number of calls. As always, for the fastest service, please advise your clients to encourage their employees to begin claims online at unum.com/employees/file-a-claim.
We’re keeping you up to date on changing regulations and assistance programs
Federal legislation to help mitigate the effects of the pandemic went into effect last week, but information on employer responsibilities and resources is evolving. The Department of Labor is regularly updating its guidance, even as additional state and federal legislation moves forward.
We are closely monitoring the evolving details around leave, assistance programs for small business, and overall regulatory implications for our customers. We’re committed to providing you and your clients with frequent updates. For the latest information, please refer to these resources:
• Our COVID-19 legislative updates and FAQs
• Our latest HR Trends podcast, with Unum legal and leave experts discussing the new regulatory environment, as well as small-business incentives such as the Paycheck Protection Program
• Our recent webinar on the most recent updates to the Families First Coronavirus Response Act
The impact of COVID-19 is hard to believe. But our commitment to you and your clients is unwavering. We will continue to help you make sense of legislative developments and other events that impact your business and your clients in the weeks and months to come.
Please reach out to your closest Unum representative with any questions you may have. As always, thank you for allowing us to partner with you to protect your clients, their employees and their families.
COVID-19 Frequently Asked Questions
COVID-19 legislation web page
As the COVID-19 emergency disrupts business for a second month, we realize your information needs may be shifting. It’s critical to understand regulatory changes, but at this point you may also be interested in other ways to help your clients support their employees.
In addition to announcing process changes that will speed COVID-19-related claims, we’d like to share some things we’re doing to safeguard our employees’ well-being while they work from home.
As a large employer, we have internal experts, perspective and resources that may help your clients think through their own approaches to supporting their teams in today’s environment.
Expert advice on how to support the at-home workforce
Last month we transitioned 99% of our employees to working from home, to help slow transmission of the virus and to protect their health and well-being.
In the process, we’ve discovered some things about helping employees stay healthy, connected and productive. In our recent HR Trends podcast episode, our Assistant Vice President for Global Wellbeing & Health Management Laurie Mitchell shares some of the lessons we’ve learned and approaches we’ve taken to support our employees’ well-being, from emphasizing self-care to ensuring regular, more personal communication from leadership.
Please feel free to share this podcast with your clients.
Dedicated to faster claims decisions and streamlined communication
Our commitment to serving you and your clients during the pandemic is unwavering. As we strengthen our ability to handle COVID-19-related claims, we’ve made some further operational changes that will help ensure we provide the best-in-class service employees need and deserve:
• In addition to a dedicated team to manage Leaves related to the FMLA expansion program, we established a second team dedicated to handling all Short Term Disability and Leave claims related to COVID-19.
• The new team will use streamlined processes for working with internal and external partners to enable faster decision making. For example, we are forgoing some medical-record requests, as many providers are unable to provide records promptly.
• Communication processes have also been simplified to minimize delays.
With these structural changes, we’re better prepared to handle claims as they increase.
As legislative and regulatory guidance changes, we’re keeping you informed
Specifics are still surfacing around federal and state legislation to help employers and employees cope with the pandemic. As relevant updates become available, we’ll continue to post them on our COVID-19 legislative updates and FAQ pages.
We sincerely hope you are coping well during this extraordinary time. Please reach out to your closest Unum representative if you have any questions we can answer or assistance we can provide.