COVID-19 Update: March 13, 2020
March 13, 2020
Parker, Smith & Feek will be providing a weekly recap of changes and updates that may impact your employees during the COVID-19 outbreak.
Please use this document as a reference. You may receive more urgent information and carrier-specific details through our Benefit Alerts or from your Parker, Smith & Feek account managers.
COVID-19 TESTING AND OTHER COVERAGE MANDATES
For fully insured plans in Washington State, Insurance Commissioner Mike Kreidler issued a mandate for health insurers to waive copays and deductible for FDA-approved testing for COVID-19 without the need for prior authorization. This applies through May 4th to all state-regulated health insurance plans and short-term limited duration medial plans. Insurers must also allow a one-time early refill for prescriptions. View Commissioner Kreidler’s order here: WA OIC Emergency Order No. 20-01 03.05.2020.
If your plan is self-insured, it is regulated by federal rather than state rules. This means that the Washington State mandate is not required, but the employer as the plan sponsor has the option to adopt the Washington State regulations.
This would include testing with no cost sharing and allowing early refills through your retail pharmacy benefit. The cost of testing is estimated at $200 per test, not including the physician visit. If you are self-insured and wish to follow the mandate, please work with your Parker, Smith & Feek account team on plan amendments.
High Deductible Health Plans (HDHPs) with a Health Savings Account (HSA). HSAs are regulated by the Internal Revenue Service (IRS). The IRS determined that HDHPs with an HSA may cover COVID-19 testing without a deductible, as they have deemed the testing preventive.
The notice applies broadly to “all medical care services received and items purchased associated with testing for and treatment of COVID-19.”
IRS Notice 20-15 03.11.2020
For individuals who may not have insurance or may lose eligibility, the State opened up the Washington Health Benefit Exchange for a limited-time special enrollment period that runs through April 8th, 2020.
WA Healthplanfinder Special Enrollment 03.10.2020
For healthcare workers, the Washington Department of Labor and Industries announced there will be workers’ compensation coverage for quarantined health workers and first responders.
WA Governor Announcement 3.5.20
Washington State Provided Benefits – Scenarios
The Washington State Employment Security Department has created a cheat sheet with possible workplace and worker scenarios, and what benefits may be supportive, including:
- Employer paid sick leave
- Unemployment insurance
- Paid family and medical leave
- Industrial insurance (L&I)
We found this to be very useful in preparing for conversations with employees who are quarantined, self-quarantined, and may become ill.
WA ESD COVID-19 Scenarios & Benefits 03.12.2020
Additionally, workers might be eligible for unemployment due to a reduction in hours. For more information, visit the WA ESD Programs To Help Individuals & Employers 03.12.2020
For OSHA recordkeeping, COVID-19 is a recordable illness if a worker is infected on the job. This is different than the regular cold or flu.
OSHA Recording Workplace Exposures to COVID-19 undated
If you have employees or family members who are on Medicare, here is the latest on Medicare benefits for testing and treatment:
CMS Medicare Coverage & Payment Related to COVID-19 03.05.2020
WHAT’S HAPPENING AROUND THE COUNTRY?
If you are curious about what is happening in every state with employment and benefits in response to the COVID-19 crisis, the National Association of Insurance Commissioners is maintaining a website that includes links to all state resources and announcements:
National Association of Insurance Commissioners Website
We are providing information from states where decisions have been announced, as of the time of this publication. This is a very dynamic situation and our next report will include any changes in other service areas. Use the links provided to find up to the minute information about your state.
California
Just like Washington State, the State of California has announced that they will also be mandating free medically necessary COVID-19 testing for fully insured plans. This does not apply to self-insured plans, where the employer has the option to follow the mandate. For more details, visit:
CA Department of Health COVID-19 Testing 03.05.2020
For more California news and updates:
CA Department of Health News Releases
State health departments with updated resources:
DISCLAIMER
This article is provided for informational purposes only and is not intended to provide legal or actuarial advice. The issues and analyses presented in this article should be reviewed with outside counsel before serving as the basis of any legal or other decision.
The views and opinions expressed within are those of the author(s) and do not necessarily reflect the official policy or position of Parker, Smith & Feek. While every effort has been taken in compiling this information to ensure that its contents are totally accurate, neither the publisher nor the author can accept liability for any inaccuracies or changed circumstances of any information herein or for the consequences of any reliance placed upon it.
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